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Musculoskeletal disorders (MSDs), encompassing low back pain, inter-vertebral disc disorders, carpal tunnel syndromes, disorders of muscle ligament and fascia, sprains and strains of joints and adjacent muscles, are common among working people. While many occupational factors are known to increase the risks for MSDs, there is little information about the disease burden and healthcare costs of work-related MSDs.Healthcare utilisation data was extracted from the database of National Health Insurance (NHI), which is a compulsory healthcare insurance program covering up to 99% of residents of Taiwan. Numbers of outpatient visits and hospitalisation with a primary diagnosis of MSDs and their healthcare costs among the beneficiaries aged 20–65 years old were analysed. Prevalence of self-reported MSDs and exposure prevalence of major ergonomic risk factors by employment sectors were derived from a national representative survey of working people conducted in 2013.The one-year prevalence of self-reported MSDs among working men and women were 58.9% and 65.9%, and exposure prevalence rates of any type of ergonomic risk factors among working men and women were 41.2% and 35.4%, respectively. Annual healthcare expenditures for MSDs were over 158 million USD. Preliminary analyses of disease burden estimated that up to 8500 men and 7000 women developed work-related MSDs that required outpatient treatments or hospitalisation in one year. In contrast, only 434 cases of MSDs were recognised and compensated by the workers’ compensation insurance in the same year, suggesting a severe under-recognition of work-related MSDs.Work-related MSDs constitutes a major occupational health concern with substantial disease burden and healthcare costs. While it is important to prevent work-related MSDs, it is equally important to readjust financing strategies to ensure that employers take responsibility for healthcare costs due to occupational factors.