The purpose of this study was to analyze factors associated with musculoskeletal disorders and disability in elementary teachers. This is a cross-sectional study from a representative sample of Brazilian elementary teachers (n = 530). Data were collected using a self-report questionnaire. Sociodemographic, work-related, and behavioural characteristics were the exposure variables. The outcomes were musculoskeletal symptoms, disability, and musculoskeletal disease. Musculoskeletal disease was used as an outcome, as well as an exposure variable when musculoskeletal symptoms and disability were the outcomes. Prevalence ratios (PR) were estimated by Poisson regression. Variables associated with musculoskeletal symptoms were: length of employment ≥20 years (PR = 1.41), perception of inappropriate infrastructure of schools (RP = 1.21), physical activity (PR = 0.80), and high stress (PR = 1.16) for upper limbs; high stress (PR = 1.23) and perception of inappropriate infrastructure of schools (RP = 1.16) for back/neck; common mental disorders (PR = 1.14 to 1.30), and musculoskeletal disease (PR = 1.19-1.62) for all regions of the body. Musculoskeletal disease (PR = 2.46 to 3.37) and perception of inappropriate infrastructure of schools (PR = 1.53 to 1.95) were associated to disability in all regions of the body. Length of employment >20 years was associated with disability in the upper limbs (PR = 2.06). Common mental disorders were associated with disability in the upper limbs (PR = 1.53) and back and neck (PR = 1.47) while sitting time >120 min/day was inversely associated with disability in the lower limbs (PR = 0.64). The predictors of musculoskeletal disease were length of employment ≥20 years (PR = 1.97), perception of inappropriate infrastructure of schools (PR = 1.57), strength and flexibility activities (PR = 1.66), TV viewing time ≥ 120 min (PR = 1.37), sports practice (PR = 0.39), and common mental disorders (PR = 1.39). Although the associations varied according to the outcome, common mental disorders, perception of inappropriate infrastructure of schools, high stress, and length of employment are variables to be considered in the prevention of musculoskeletal disorders in teachers. When analyzed as an exposure variable, musculoskeletal disease was the main predictor of musculoskeletal symptoms and disability.