Purpose: While the extant literature has mainly examined either organisational justice or performance appraisal on employee attitudes, studies assessing the effect of performance appraisal justice (PAJ) on employee work attitudes are very limited. Hence, this study aims to investigate the effects of PAJ on employee work attitudes (job satisfaction and employee commitment) using empirical insights from health-care workers in Ghana. Design/methodology/approach: The study collected data from 302 workers in six selected health-care institutions and used multiple regression and bootstrapping mediation methods for the analyses. Findings: This study found that interpersonal and procedural PAJ has significant positive effects on job satisfaction, but distributive PAJ showed an insignificant positive outcome. Then, while distributive and procedural PAJ has significant positive effects on employee commitment, interpersonal PAJ was insignificant. Moreover, job satisfaction significantly mediated the relationship between employee commitment and the three dimensions of PAJ. Practical implications: This implies that PAJ can trigger positive employee work attitudes such as job satisfaction and commitment to facilitate the realisation of positive health-care outcomes if fairness and justice are effectively integrated into performance appraisal practices in health-care institutions. Originality/value: The study contributes to extending organisation and human resource theories in the context of health-care services by applying the organisational justice theory to understand the job attitudes of workers in the health-care sector and institutions--a highly under-research context with respect to the topic.