Effective occupational health psychology (OHP) interventions are evidence-based strategies that address the increasing costs of occupational stress and poor well-being. However, the evidence that OHP interventions successfully reduces these costs remains ambiguous. This systematic review of OHP interventions assessed the theoretical basis informing recently published interventions, the outcomes targeted, and the evaluation methods they used. Using a comprehensive search strategy of 25 years of international OHP intervention research, 60 journal articles representing 59 unique interventions met criteria for inclusion. Articles were coded and data analyzed using content analysis. Results identified that 53% of these interventions were not explicitly theory based and their outcomes were poorly defined. We identified considerable construct proliferation and a pathogenic bias in distal intervention outcomes. Most of the experimental evaluation methods used were focused on demonstrating an effect existed—on average within a group—to the exclusion of assessing the costs and benefits of an intervention. In combination, these results suggest this field too often reports interventions adopting a trial-and-error approach, which demonstrates inadequate integration with theory, and reports outcomes that are not easily comparable between studies. We discuss these findings and present 3 sets of recommendations for addressing these concerns and to advance both knowledge and practical outcomes for OHP interventions.