BACKGROUND Dairy farming is physically demanding and associated with a high frequency of musculoskeletal disorders (MSD). This study investigated and compared work-related MSD, ergonomic work factors and physical exertion in farmers and employed farm workers on dairy farms in Sweden. METHODS The study comprised 66 dairy farmers, and 37 employed dairy farm workers. A modified version of the general Standardised Nordic Questionnaire was used for analyses of perceived MSD in nine different parts of the body. Perceived physical discomfort was assessed using questions concerning ergonomic work factors. A rating scale was used for analyses of perceived physical exertion. Information about participant demographics was also collected. The response rate amounted to 70%. RESULTS The most frequently reported MSD in farmers and farm workers were located in the lower back (50% and 43%, respectively) and the shoulders (47% and 43%, respectively). MSD were also frequently reported in the neck (33%) among farmers, and in the hands/wrist (41%) among farm workers. MSD in the elbows (23%) and feet (21%) were significantly more frequently reported by farmers than farm workers (5%). Female farmers and farm workers both reported significantly higher frequencies of MSD in the neck (48% and 56%, respectively) and hands/wrists (44% and 61%, respectively) than their male colleagues (24% and 5%; 10% and 21%, respectively). In addition, female farm workers had significantly higher reported frequencies of MSD in the upper and lower back (39% and 61%, respectively) than their male counterparts (5% and 26%, respectively). Milking was perceived as a weakly to moderately physically demanding work task. Repetitive and monotonous work in dairy houses was the ergonomic work factor most frequently reported as causing physically discomfort among farmers (36%) and farm workers (32%), followed by lifting heavy objects (17% and 27%, respectively). Female workers had significantly more reported discomfort from repetitive and monotonous work than their male counterparts (50% and 16%, respectively). CONCLUSIONS Despite the technical developments on modern dairy farms, there is still a high prevalence of MSD and discomfort from ergonomic work factors, particularly among female workers.