In contemporary society, middle-aged women tend to experience limited leisure time and shrinking social networks as they simultaneously perform multiple roles, including childrearing, parental caregiving, household labor, and paid work. These constraints on leisure and reductions in social relationships are likely to lead to declines in psychological well-being and physical health. Accordingly, this study examined the effects of supportive social relationships on psychological well-being and physical health among middle-aged women, focusing on the mediating roles of social and personal leisure activities. The results indicated that supportive social relationships had direct positive effects on both psychological well-being and physical health and were significantly and positively associated with both social and personal leisure. Furthermore, the indirect effects of supportive social relationships on psychological well-being through leisure were significant for both social and personal leisure, whereas for physical health, only social leisure showed a significant mediating effect. This study contributes to the literature by identifying the structural pathways through which supportive social relationships influence well-being and health via leisure activities. In addition, the findings highlight the importance of leisure participation grounded in social relationships for improving the quality of life of middle-aged women and suggest practical implications, including the development of community-based leisure networks, support strategies to alleviate caregiving burdens, and active leisure programs that integrate opportunities for social interaction.