The primary purpose of this research was to determine the effect of principal instructional leadership behavior on several determinants: organizational commitment, efficacy, and teacher satisfaction through school health. Five instruments that had been used are the principal instructional management rating scale (PIMRS); organizational health inventory for elementary schools (OHIE); online course questionnaire (OCQ); teacher satisfaction scale (TSS); teacher efficacy scale (TES). All of these instruments had high validity and reliability; with Cronbach's alpha values of each was PIMRS (0.83), OHI-E (0.81), OCQ (0.80), TSS (0.86), and TES (0.79). A total of 350 public primary school teachers in Surakarta had been selected as respondents in this study with satisfied random sampling. AMOS software version 6.0 is used to analyze CFA and SEM. The results of SEM analysis to the structural model built by the researcher was good, with Probability = 0.001; RMSEA = 0.043; GFI = 0.941; AGFI = 0.907; CMIN/DF = 1.522), so the relationship between the variables in the constructs was interpreted; (1) The Principal instructional leadership behavior had a significant direct influence on the school health, (2) The school health parameter had a significant direct influence on organizational commitment, efficacy, and teacher satisfaction, (3) The principal instructional leadership behavior did not have a significant direct effect on organizational commitment, efficacy, and teacher satisfaction through the variables and school health.