Occupational physical activity (OPA) and leisure-time physical activity (LTPA) may have differential effects on health. Recent work, including the dissertation by Cillekens, has demonstrated that these activity domains show markedly different associations with morbidity and mortality in (mainly) Western populations. However, little is known about whether similar patterns are present in South Korea. This narrative review aimed to place the findings from Cillekens’ dissertation on OPA and LTPA in the context of Korean workers. A PubMed search identified studies published within the last 10 years using terms related to OPA, LTPA, and Korea. Twenty studies were included, mostly cross-sectional, drawing on data from the Korea National Health and Nutrition Examination Survey and other cohorts. Health outcomes covered cardiometabolic health, musculoskeletal outcomes, mental health, sleep, work functioning and quality of life, inflammation and renal outcomes, and urogenital and airway diseases. Across outcomes, higher OPA was generally associated with no or adverse health outcomes, whereas higher LTPA was consistently associated with favorable health outcomes. The differential associations of OPA and LTPA observed in Western populations are also evident in Korea, aligning with conclusions from prior large-scale analyses such as the dissertation by Cillekens, which consistently demonstrated adverse or null effects of high OPA and beneficial effects of LTPA. Achieving recommended activity levels through LTPA, rather than OPA, appears most advantageous for overall health. These findings suggest several practical implications: physiotherapists and occupational health professionals can play an important role in supporting workers by helping to reduce occupational demands, promote adequate recovery, and provide tailored exercise programs aimed at maintaining or improving cardiorespiratory fitness and musculoskeletal health. Collectively, the evidence supports revisiting public health guidelines to emphasize LTPA rather than total activity, underscoring that not all physical activity domains contribute equally to health.