Objective: Epidemiological data on saxophonists’ health is limited, often lacking cultural context. This exploratory study aims to compare musculoskeletal pain, musician identity, music performance anxiety, and mental health issues between Chinese-speaking (CS) and English-speaking (ES) saxophonists exploring how these factors may differ across cultural groups. As an exploratory study, this research does not seek to establish definitive causal relationships but rather to provide preliminary insights that may guide future investigations. Methods: A convenience sample of 325 male saxophonists (230 ES and 95 CS) was recruited through the online distribution of a web-based survey. An initial sample of 390 participants was obtained; however, 65 were excluded due to insufficient female representation. We utilized interactive web-based body and hand maps to assess the prevalence, frequency, intensity, and influence of musculoskeletal (MSK) pain on performance at specific body sites. Additionally, participants reported on psychological experiences including depression, anxiety, music performance anxiety (MPA), and musician identity. A MANCOVA was employed to compare musculoskeletal pain, musician identity, music performance identity, and mental health issues between the two groups. While statistical adjustments were applied to account for sample imbalances, these findings should be considered preliminary observations rather than conclusive evidence. Results: CS participants reported significantly lower scores on the social identity aspect of musician identity. The prevalence of saxophone-related MSK pain is 79% for ES saxophonists and 59% for CS saxophonists. In the ES sample, the neck (38.5%) was the most prevalent pain site, while in the CS sample, the orofacial (42.3%) was the most prevalent. Pain at the orofacial was reported to influence performance the most across the two samples. While CS participants reported significantly lower scores on non-MSK problems, they reported significantly higher MPA frequency and intensity than ES participants. Conclusion: This study represents the first known investigation to consider the cultural context within saxophone-specific health research. Both samples experience MSK and non-MSK problems, with experience-related factors and cultural differences possibly contributing to the different pain patterns observed between ES and CS saxophonists. The results suggest emerging patterns in how cultural background may influence musician identity and health-related experiences. The study highlights the importance of cultural considerations in musician training and well-being and provides a foundation for future research with larger and more balanced samples.