In a case-control study of a population-based telephone survey of 3,798 working adults, symptoms of work-related musculoskeletal disorder (WRMSD) were associated with biomechanical, psychosocial, and organizational factors. In several models, biomechanical exposures with strong associations were static postures (odds ratios [ORs] = 2.00-5.45); repeated pushing, pulling, lifting (ORs = 1.86-12.75); and repeated neck bending (ORs = 1.07-12.8). Psychosocial and organizational factors consistently retained in these models were demands (ORs = 1.26-1.59) and organizational support (ORs = 0.53-0.79). Decision latitude entered less frequently (ORs = 0.30-0.49). This research may have implications for intervention strategies. First, reducing both biomechanical and psychosocial risk may be more effective than focusing solely on engineering controls. Second, organizational culture and policy may have strong implications for WRMSD prevalence and control.