A national sample of 60 male and 61 female adults completed a telephone interview that included measures of hypochondriacal tendencies, psychological distress, and symptom manifestation. They also provided cognitive evaluations for their most important health goal on scales measuring self-efficacy, value, planning, self-reward, self-criticism, self-monitoring, social comparison, and positive and negative goal-based arousal. Health goal cognition significantly predicted hypochondriacal tendencies measured 15 to 30 days after the goal assessment, even after controlling for chronic illness diagnosis. Correlations between goal cognition and hypochondriacal tendencies differed from those observed for psychological distress, and no significant correlations emerged with symptom manifestation. Results support a motivational account of hypochondriacal tendencies and extend previous goals research.