This article explores factors associated with positive self-perceived health among Canadian seniors who live in health care institutions. Cross-sectional and longitudinal data are from the institutional and household files of the National Population Health Survey (NPHS). Prevalence rates of positive self-perceived health were estimated using 1996/97 cross-sectional data from the NPHS. Logistic regression models were used to identify factors associated with positive self-perceived health. With four cycles of longitudinal data, the relationship between positive self-perceived health and mortality was explored using survival analysis. In 1996/97, 43% of the institutional population aged 65 or older reported positive self-perceived health. Institutional residents with positive self-perceived health had a lower risk of mortality. The odds of positive self-perceived health were higher for those who were usually free of pain and were independent. Participation in social and recreational activities and having a close relationship with at least one staff member of the institution were associated with positive self-perceived health.