This paper interrogates two different perspectives on music and wellbeing. The first positions musical practice as being beneficial for emotional wellbeing and mental health, whilst the second positions musical work – building a career as a musician – as potentially detrimental. This apparent paradox matters because the clinical findings which establish a causal link between music and wellbeing are being disembedded from the contexts in which those links are manifesting by charities, social enterprises, advocacy organisations, educational institutions, governments and international bodies, and fuelling normative sociological prescriptions which encourage participation in music making. For those who go on to develop career ambitions, wellbeing outcomes are far less clear. Therefore, a more sophisticated appreciation of the uses of music and its impact on wellbeing is required. This paper provides a more balanced view of the connections between music, wellbeing and health and reflects on how this paradox might be resolved.