This study explores the health-related implications of both individual students’ and class-level concentrations of perceived demands in terms of pressuring, difficult and tiring schoolwork in France and Sweden, two countries with substantial differences in their educational systems and recent notable differences in PISA-results. Data come from Health Behaviour in School-aged Children (2001/02, 2005/06 and 2009/10) and comprise a total of 33,243 students aged 11, 13 and 15. Findings show that feeling under pressure from schoolwork is less prevalent in Sweden than in France among 11 and 13-year olds, but almost twice as common among 15-year olds. Yet its correlation with 15-year olds’ psychosomatic complaints is stronger in France than in Sweden. Feeling tired by schoolwork is equally common for 11- and 13-year olds in the two countries, but more frequent among 15-year olds in Sweden. It is also a stronger predictor of psychosomatic complaints in Sweden than in France across all age-groups. While it is more common at all ages to perceive the schoolwork as difficult in France, its relationship with psychosomatic complaints is stronger among students in Sweden. The proportion of classmates reporting high school demands is also linked to poorer student health, but these effects were largely confined to girls in both countries.