Children’s learning during the primary school years is strongly linked to later outcomes such as school engagement, school completion rates and employment. Therefore, understanding factors that may limit children’s ability to achieve their optimal learning outcomes during this time is of education policy and practice interest. One area which has been identified to negatively influence children’s learning are physical and psychosocial health difficulties. However, previous studies examining this relationship has predominantly focused on single health problems instead of examining a wide range of difficulties a child may experience concurrently. Therefore, this paper addresses this gap by exploring the cumulative effect of the number of physical and psychosocial health difficulties with concurrent and subsequent cross-sectional and longitudinal academic achievement.This study will present data from Australia’s only nationally-representative, longitudinal cohort, The Growing Up in Australia Study. This study enrolled 5000 Australian children in 2004 when children were 4-5 years old. Every 2 years, parents, children and teachers have provided data using validated measures about the child’s development, health and education outcomes. In addition, data linkage was available for children’s Year 3 and 5 NAPLAN results. We found that when children were 8-9 years old, 23.9%, 9.9% and 5.3% had 1, 2 or ≥3 physical health difficulties, respectively, while 27.2%, 9.5% and 4.9% had 1, 2 or ≥3 psychosocial health adversities, respectively. For each additional health adversity at 8-9 years, academic scores fell incrementally in Year 3 and up to two years later in Year 5 (both p<0.001), with reductions of at least 0.5 standard deviations for ≥3 health difficulties. The number of difficulties was more important than type (physical, psychosocial) in terms of poorer Year 3 and Year 5 academic scores.Our findings suggests that improving children’s academic outcomes may require multiple domains of physical and psychosocial health to be addressed. Responding to these needs by education and health systems will require testing of both multi-informant identification systems and a broad range of evidence-based support, whose effectiveness is demonstrated not only as stand-alone supports but within flexible, coordinated service programs that can be delivered across the interface between education and health systems. Despite continued advocacy regarding the health-education interface, the evidence gaps remain large and the potential academic benefits unrealised.