<p>Work-related musculoskeletal disorders are the major public health problems globally. Despite the vital role sonography service providers play in diagnostic healthcare delivery, there is a paucity of studies addressing the magnitude and determinants of work-related musculoskeletal disorders among Sonography service providers in Ethiopia. Therefore, this study sought to determine the prevalence and factors associated with work-related musculoskeletal disorders among sonography service providers in the Gamo and Wolaita Zones of Southern Ethiopia. An institution-based, cross-sectional study was conducted using simple random sampling in public and private hospitals in the Gamo and Wolaita Zones, southern Ethiopia, from September to November 2024. A total of 313 participants working at public and private health facilities in the study area were included. Data were collected using a pretested, structured self-administered questionnaire. The analysis was done using SPSS version 27. Bivariate and Multivariable logistic regression analyses were employed to determine the association. The <i>P</i>-value of &lt; 0.05, with its corresponding 95% confidence interval, was used to compute the strength of association. Three hundred thirteen sonography service providers participated in this study, giving a response rate of 98.74%. The prevalence of work-related musculoskeletal disorders among sonography service providers was 79.6% (95% CI [74.48–83.99%]). Regarding the parts of the body involved, the shoulder (57.03%), neck (24.09%), elbow/wrist/hand (16.06%), and lower back (2.8%) were the most common. Lack of height adjustable ultrasound screen (AOR = 2.945, 95%CI [1.33–6.53]), alternating posture with periodic breaks (AOR = 0.22, 95%CI [0.093–0.55]), having no work fatigue (AOR = 0 .088 95%CI [0.022–0.35]) and having no break times during the work day (AOR = 4.06, 95%CI [1.27–12.90]) were significantly associated with work related-musculoskeletal disorders. A high prevalence of work-related musculoskeletal disorders was observed. Having no work fatigue, static posture, lack of adjustable equipment, and insufficient work breaks were significantly associated with work-related musculoskeletal disorders, suggesting a potential role of workplace ergonomics and work practices. Interventions focusing on ergonomic improvements, structured work-rest schedules, and promotion of proper body mechanics may help reduce the burden of work-related musculoskeletal disorders.</p>