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Work related musculoskeletal disorders (MSD) accounts for a significant share of post-workday injuries and illnesses and hence constitute a major proportion temporary or permanent disability among garment industry workers in many countries. Bangladesh is now one of the world’s leading clothing exporters, and the garment industry employs more than 3.6 million workers in its 4500 factories. However, musculoskeletal disorders become a major health problem for seeking health care and an important cause for absenteeism which is a major concern among owners of the factories and policy makers.The aim of this study was to estimate the magnitude of musculoskeletal disorders among workers in a large garment industry in Bangladesh.Review of 34 264 records of patients attended the outpatient department of the health care centre of the selected garment industry during April 2015 to April 2016 has been done to identify and compute the musculoskeletal disorders in order to calculate the proportion of MSD. A checklist was used to collect data from the outpatient registers.More than 4500 workers are enrolled in the different sections of the selected garment industry. Out of the total 34 264 outpatient attendants, 8039 (23%) sought care for musculoskeletal disorders. On an average 25 MSD patients sought medical help for the management of their health problem. The incidence of MSD in the garment factory is 164.9 per 100 worker years. Of the total patients, 49 cases were referred to the higher level of hospital.Work related MSD is a major health problem among garments workers in Bangladesh, which might cause a significant absenteeism in the work. It is important to identify appropriate intervention including improvement of working environment to prevent MSD among garment workers to sustain the pace of development in this sector.