BACKGROUND: Work-related musculoskeletal pain (WRMSP) among cardiac sonographers has been incompletely studied. The aim of this study was to compare the frequency, magnitude, and impact of WRMSP among cardiac sonographers with those of a control group of peer employees. METHODS: An electronic survey was sent to cardiac sonographers and peer employees assigned to different occupational exposures within the Department of Cardiovascular Medicine at 10 Mayo Clinic facilities in four states. RESULTS: A total of 416 subjects completed the survey: 111 sonographers (27%) and 305 peer-employee control subjects (73%). The mean age was 43 ± 11 years, and 307 subjects (74%) were women. The sonographers' response rate was 86%. WRMSP was experienced by a large majority of sonographers (95 [86%] vs 140 [46%] for control subjects, P < .001). This association persisted after multivariate adjustment (odds ratio, 8.18; 95% confidence interval, 4.33-15.46; P < .001). Compared with coworkers, sonographers' pain was perceived as more severe (pain score > 5 on a 10-point scale; 62% vs 29%, P < .001) and as getting worse (14% vs 2%, P < .001). The neck (58% vs 25%), shoulder (51% vs 11%), lower back (44% vs 26%), and hand (42% vs 9%) were the most frequently affected body regions (P < .001 for each). The presence of WRMSP in sonographers was more often associated with interference in performance of daily (37% vs 12%, P < .001) and work-related (42% vs 11%, P < .001) activities. Because of pain, sonographers more often sought medical evaluation (27% vs 12%, P < .001), missed work (13% vs 4%, P < .001), had work restrictions (5% vs 0.6%, P = .005), and were considering changing employment (9% vs 0.5%, P < .001) compared with control subjects. CONCLUSIONS: WRMSP in cardiac sonographers is much more prevalent and severe compared with peer employees. WRMSP in sonographers affects daily and work-related activities, as well as future employment plans. Further studies assessing the potential role of preventive interventions are needed.