AIM: The purpose of this study was to analyse whether development in self-rated health (SRH) over four years was associated with the structure of and satisfaction with social relations, at four and eight years follow-up, among elderly women and men. METHODS: A longitudinal questionnaire-based study was undertaken of non-institutionalized Danes, aged 70-95 years, with baseline in 1986. The response rate at baseline was 69%, n= 1,231. First follow-up was carried out in 1990, with 91% of eligible individuals participating (n=911). Second follow-up took place in 1994, where 83% of eligible individuals participated (n= 542). The association was studied between development in SRH from 1986 to 1990 and social relations in 1990 and in 1994. RESULTS: A sustained poor SRH predicted low contact frequency OR= 1.7 (1.1-2.6), small contact diversity OR= 1.6 (1.0-2.6) and low contact satisfaction OR=3.4 (2.3-5.2) in the two-point analyses. Furthermore, a deterioration in SRH predicted poor contact satisfaction OR=2.8 (1.7-4.5). All analyses were adjusted for age, gender, mental health, functional ability, cohabitation status, and a measure of social relations at baseline. Results for the three-point analyses were similar to those for the two-point analyses. The associations were weaker for contact satisfaction OR=2.8 (1.7-4.7), but stronger for contact frequency OR=2.5 (1.4-4.4) and diversity OR=2.1 (1.2-3.6). CONCLUSION: Sustained poor SRH and, to some degree, deterioration in SRH were predictors of poor social relations after four and eight years.