Harmonium, a commonly played instrument, requires repetitive movements, awkward playing postures, and intense practice routines which may place the musician at risk for injury. This study aimed to determine the prevalence of musculoskeletal pain and analyze the postural risk in harmonium players. A cross-sectional study was conducted on 80 harmonium players who received at least 7 consecutive years of formal training. A self-designed questionnaire comprising demographic profiles, playing characteristics, presence of musculoskeletal pain, and specific areas of pain was administered. Postural risk was evaluated using a rapid upper limb assessment tool. Among 80 harmonium players, 34 (42.5%) and 52 (65%) reported musculoskeletal pain for 12-month and 7-day prevalence, respectively. The most common site of pain was the lower back, followed by the knee, shoulder, wrist, and hand. Also, there was no significant difference between the harmonium players with pain and without pain for body mass index, duration of playing harmonium, and harmonium exposure. It was observed that 62 (77.5%) players were in the category of low risk for injury and 18 (22.5%) were in the medium-risk category for developing musculoskeletal disorders. A high prevalence of musculoskeletal pain was observed in harmonium players. The posture adopted by players predisposed them to the development of musculoskeletal disorders as per the risk assessment.