In this cross-sectional investigation of female garment workers the prevalence of soft tissue disorders of the hands and arms was studied. The findings were compared with the prevalence of disorders in a group of female hospital employees not required to use repetitive hand motion. One hundred and eighty-eight garment workers and 76 hospital employees were surveyed by questionnaire and physical examination. The prevalences of persistent shoulder, wrist, and hand pain were significantly greater among the garment workers (rate ratio 2, 4, and 3, respectively). In both groups about 60% of the persistent hand pain was consistent with carpal tunnel syndrome (rate ratio 3). These associations held when the comparisons were stratified by age and by length of employment. Workers whose native language was not English were significantly less likely to report symptoms (rate ratio 0.6). Workers in hand sewing and trimming suffered especially high prevalences of persistent pain in all upper limb sites. Stitchers had elevated rates of pain in the shoulders, wrists, and hands. Workers ironing by hand had a significant elevation in elbow pain rates. Garment assembly tasks appear to be associated with cumulative trauma of the hands and wrists; the biomechanical features of these jobs should be studied in greater detail.