Background This study aimed to confirm, in a large, diverse cohort of elite Stand-up Comedians and other entertainers, that there is an inverse association between comedic ability and longevity. Methods This retrospective cohort study included 200 Stand-up Comedians (13% women), 113 Comedy Actors (17.5% women), and 184 Dramatic Actors (29.3% women) listed in the top 200 in each category in a popular online ranking website. Longevity within each group was examined adjusting for life expectancy by year of birth and within-group ranking score. Results Stand-up Comedians were younger than Comedy Actors (median birth year 1962 versus 1947: p < 0.001) and Dramatic Actors (1962 versus 1946: p < 0.001). Overall, 36/200 (18.0%), 33/114 (29.0%) and 56/184 (30.9%) of Stand-up Comedians, Comedy Actors and Dramatic Actors, respectively, had died (p = 0.011). There was a significant gradient (p = 0.011) in the age of death, with Stand-up Comedians dying at a younger age (67.1 ± 21.3 years) than their Comedy Actor (68.9 ± 15.4 years) and Dramatic Actor (70.7 ± 16.6 years) counterparts. Stand-up Comedians (38.9% versus 19.6%) were more likely to die prematurely compared to Dramatic Actors; p = 0.043, OR 1.98; 95% CI 1.01 to 3.87). Independent of year of birth, for Stand-up Comedians alone, higher comedy rank was associated with shorter longevity (hazard ratio 0.938, 95% CI 0.880 to 0.999 for a 10-rank difference; p = 0.045). Conclusions These data reaffirm an adverse relationship between comedic ability and longevity, with elite Stand-up Comedians more highly rated by the public more likely to die prematurely.