A 1-year follow-up of two preadolescent age cohorts with musculoskeletal pain at least once a week was conducted to analyze predictive factors for the persistence of musculoskeletal pain. Of the 564 children with pain at baseline, representing one third of the sample studied, 515 (91.3%) could be followed and 452 (80.1%) children with complete data were included for the logistic regression analysis. A structured questionnaire included questions on pain and also on several psychosomatic symptoms and amount of exercise. Joint hypermobility together with the questionnaire data were included in the logistic regression analysis. One half of subjects with pain at baseline still reported pain at follow-up, indicating persistent pain. Boys had a lower risk for the persistence of pain than girls and the risk for the persistence of pain increased 1.2 times per age year. When further adjusted for all the other studied risk determinants, high subjective disability index due to pain (OR 3.2, 95% CI 1.5-6.6) and day tiredness (OR 1.9, 95% CI 1.2-3.0) were the most significant predictors. This might indicate that psychological distress contributes to the persistence of non-specific musculoskeletal pain of different locations in preadolescents. In clinical work not only pain but its interference with daily activities should be noticed.