A prospective cohort study investigated how psychosocial work factors predict musculoskeletal pain. A total of 721 workers at 226 automobile repair garages answered two questionnaires distributed with a 1-year interval. The predictor variables were psychological demands, decision authority, social support, and management support. The outcome variables were neck pain, low back pain, and an index of pain from seven different parts of the body in the past 30 days. The best predictors were low decision authority and management support. Low decision authority predicted neck pain, low back pain, and total musculoskeletal pain when adjusted for the effect of the respective musculoskeletal pain measured in the first survey, for age, and for gender. Low management support predicted both low back pain and general musculoskeletal pain. The study indicates that psychosocial factors at work may predict musculoskeletal pain.