Manual handling activities have long been recognized as major contributors to occupational injury and ill health. Following a series of consultative documents, the Manual Handling Operations Regulations (MHORs) and their associated Guidance came into force in the UK in January 1993. More than 5 yr on, an investigation was performed to evaluate response to this legislation amongst a random selection of small businesses within a business district of Shropshire, England. A postal questionnaire was sent to 100 companies employing 5-50 workers. Responses were obtained from 80 companies, ranging from retailing to metals/engineering. Although all of the companies are likely to perform activities requiring manual handling assessments under the MHORs, many claimed never to have heard of the legislation (38%) and almost half (46%) had not performed an assessment. Compliance varied significantly by business type, with the nine companies engaged in metals/engineering reporting significantly better compliance (P < 0.05). Of the 43 companies who claimed to have undertaken assessments, 73% (32 companies) indicated that manual handling activities had been changed, with all claiming to have reduced lifting activities, a significant proportion (75%) making improvements to the working environment and over half (59%) reducing the weight of loads. Many of the companies who indicated full compliance with the legislation (21 companies) stated that the benefits to their businesses outweighed the cost of compliance. Additional factors analysed by the study include source of legislative awareness, personnel performing assessments, employee training and method used, and reasons for non-compliance with the MHORs.