Musculoskeletal problems, resulting from lifting and transferring patients, are often reported among hospital orderlies worldwide. The purpose of this study was to describe the prevalence and factors associated with musculoskeletal disorders in Thai hospital orderlies. This cross sectional study was conducted in a government tertiary care hospital (2,221-bed hospital) in Bangkok, Thailand. Data were collected over three months between April and May 2014. The self-administered questionnaires were distributed to 189 hospital orderlies. Finally, 153 hospital orderlies that met the criteria participated in the study. The results revealed that the prevalence rate of musculoskeletal disorders among hospital orderlies was 84.3%. Musculoskeletal disorders were present in various body parts with the lower back being reported most often (74.4%), followed by hips/thighs (72.1%), and upper back (60.5%). Factors affecting causality of musculoskeletal disorders were years of employment (OR 3.9, 95% CI 0.04-0.77), repetitive movement (OR 2.7, 95% CI 0.02-0.68), heavy load handling (OR 1.2, 95% CI 0.28-2.43), and tasks that required handling patients over 30 round per day (OR 3.3, 95% CI 0.02-0.64). Findings indicate that hospital orderlies should recognize the importance of enhancing musculoskeletal health, particularly as an effective approach to risk reduction and health promotion.