BACKGROUND: Firemen are directly exposed to various harmful chemicals, physical factors and mental stress during rescue and fire-fighting. In fire extinguishing, unstable posture, poisonous gas, dust, high temperature and weighty equipments are possible hazardous factors. The alertness for emergency, shift work, job strain and stress are also possibly hazardous. Therefore, this study aimed to investigate the prevalence of musculo-skeletal symptoms and job stress and to determine risk factors in firemen. METHODS: This study was carried out in a group of 226 firemen in Busan, Korea. Standardized Nordic Questionnaire was used to investigate the prevalence of musculo-skeletal symptoms and Psycho-social Well-being Index (abbreviated PWI) was used to investigate the prevalence of job stress. General and occupational characteristics included education, marital status, alcohol and smoking history, working duration, and work shift system. Body mass index (BMI) scores were calculated by physical examination including height and weight. RESULTS: Concerning musculo-skeletal complaints, the commonest site was neck, and shoulder, lower back, upper back were the next. Complaint site above one area of body was about 80%. From multiple logistic regression analysis, working duration was significant variable in musculo-skeletal symptoms. Odds ratio were 15.4 in working duration. About 16.8% was high risk stress group. From multiple logistic regression analysis, shift work and alcohol drinking were significant variables in PWI scores. Odds ratios were 2.25 in shift work. CONCLUSION: Accordingly, interventions are needed for health promotion of long term and shift worker.