Background: Ulcerative colitis (UC) is a chronic, idiopathic inflammatory disease that affects the colon, commonly associated with systemic manifestations, and musculoskeletal disorders. Objectives: We aimed to study the musculoskeletal disordersin patients with recent ulcerative colitis (UC) compared to old cases of UC, and compared to healthy controls. Subjects and methods: 50 patients with UC and 50 healthy controls were included in case control study. They were assessed by clinical examination, laboratory investigations as well as radiological assessment. Results: The musculoskeletal disorders in cases with recent ulcerative colitis were significantly higher than that in old cases regarding morning stiffness, inflammatory low back pain, knee pain, and joint swelling, with a significant lower metabolic bone disease (MBD) in lumbar spine and femur neck in patients versus controls. Additionally, cases had significantly higher FRAX scores compared to controls. Conclusion: Our study suggests the higher rate of musculoskeletal disorders in newly diagnosed patients with ulcerative colitis compared to old cases, and that UC patients have low BMD and higher FRAX score in comparison to controls. Therefore, caution and continuous monitoring of these patients is mandatory, and treatment must be started as soon as possible for newly diagnosed cases to avoid musculoskeletal complications as well as sudden fractures.