Background: Musculoskeletal disorders (MSDs) are one of the major contributors to disability worldwide. Agricultural workers encounter different problems while doing their farming activities. These conditions may predispose them to a possible risk of MSDs. Aim: Assess the prevalence and associated risk factors of MSDs among agricultural workers. Methods: A descriptive cross-sectional study was conducted at El-Ismailia village affiliates to Minia district at Minia governorate in Upper Egypt; involving 346 subjects selected using systematic random sampling. Data were collected through two tools; the 1^st tool was a structured questionnaire to assess demographic, physical, work-related, psychosocial, and behavioral characteristics, and the 2^nd tool was the Nordic musculoskeletal questionnaire (NMQ) to assess MSDs. Results: there was a high prevalence of MSDs among agricultural workers, with approximately three-quarters (75.4%) suffering such conditions. A high prevalence was reported in specific body parts such as the lower back, knees, wrists, and shoulders (67.1%, 44.6%, 34.1%, and 28.7%, respectively). Several factors significantly increase the odds of MSDs prevalence. Males, prolonged working hours, routine heavy lifting, and working in chronic flexion positions are all associated with higher MSDs prevalence. Repetitive forceful tasks, lack of breaks, and time pressure, as well as self-medication usage, also correlate with increased MSDs prevalence. Additionally, age, lower education levels, marital status (especially widowed individuals), increase in Body Mass Index, and extensive work experience are significant factors. Psychological and behavioral characteristics, such as high levels of perceived work fatigue, low-income satisfaction, and smoking status, particularly among ex-smokers, further contribute to MSDs occurrence. Conclusion: The study reveals that MSDs are a significant occupational health issue among agricultural workers, with high prevalence in the lower back, knees, wrists, and shoulders, influenced by various personal, work-related, psychological, and behavioral factors. Recommendations: Implementing ergonomic measures, early screening of MSDs, and educational programs on body mechanics are essential to reduce the prevalence of MSDs among agricultural workers.

Findings revealed that 74.5% of participants experienced MSDs, with the lower back (67.1%), knees (44.6%), wrists (34.1%), and shoulders (28.7%) most commonly affected. Key risk factors include male gender, prolonged working hours, heavy lifting, and working in chronic flexion positions. High-risk activities such as repetitive forceful tasks, lack of breaks, and time pressure further increased MSD prevalence. Additional significant factors included age, low education levels, marital status (especially widowed), pre-obesity, and extensive work experience. Psychological and behavioral factors, including high perceived work fatigue, low salary satisfaction, and smoking (especially among ex-smokers), also contributed to MSD occurrence.

The study highlights MSDs as a critical occupational health issue for agricultural workers, driven by a combination of personal, occupational, psychological, and behavioral factors. To address this, the study recommends implementing ergonomic interventions, early screening, educational programs on proper body mechanics, and fostering international collaboration among healthcare and occupational professionals to mitigate MSD risks and improve workers' health outcomes.