Background <p>The physically intensive nature of orthopedic surgery places practitioners at a heightened risk for developing work-related musculoskeletal disorders (WMSDs). While this occupational hazard is extensively documented in a global context, a significant gap in the literature exists for low- and middle-income nations, including Nepal. This study aims to fill the existing knowledge gap by investigating the prevalence, pattern, frequency, duration, and impact of work-related musculoskeletal pain among orthopedic surgeons in Nepal.</p> Methods <p>This investigation utilized a descriptive, cross-sectional design. A self-administered questionnaire, distributed online, was completed by practicing orthopedic surgeons throughout Nepal. The survey instrument, which was adapted from the Standardized Nordic Musculoskeletal Questionnaire (NMQ), gathered information on participant demographics, occupational factors, the prevalence and nature of musculoskeletal pain, and its effects on work performance and quality of life. The collected data underwent analysis using descriptive statistics, chi-square tests, and logistic regression.</p> Results <p>This study included 251 male orthopedic surgeons, revealing that 88.9% experienced musculoskeletal pain in the last 12&#xa0;months, as defined by the Nordic questionnaire. However, this broad definition includes transient or minor symptoms and may overstate the clinical burden without considering severity, frequency, and functional impact. However, only 17.9% reported symptoms multiple times per week and 59.5% described the impact as “slight” to “mild,” indicating that many cases were episodic or mild. The most frequently affected areas were lower back (62.5%), neck (35.7%), and upper back (32.1%). Average pain intensity was 4.5 on a 10-point visual analog scale. A significant correlation was found between pain and factors, such as weekly operating hours and the use of lead aprons. This pain had a considerable professional impact, causing 18% of surgeons to miss work and 10% to consider changing their career or work practices. While many surgeons engaged in physical activity, 45.5% of those with pain resorted to self-medication.</p> Conclusion <p>While the prevalence is high, clinical burden may be overstated without considering severity and functional impact. The association between lead apron use and back pain warrants further investigation, but causal inference is limited by the cross-sectional design. Many surgeons operate while in pain, suggesting a work culture that may prioritize patient care over personal well-being, potentially risking patient safety and creating a cycle of chronic pain. This raises concerns about workforce attrition in Nepal, where specialists are limited. An evident gap also exists between surgeons' awareness of ergonomic principles and their inconsistent application in practice.</p> Limitations <p>This study relied on self-reported data, which may introduce recall bias. The sample size was limited to orthopedic surgeons in Nepal, affecting generalizability.</p>