Sewing machine operators play a vital role in the economy by producing export-ready garments. However, the repetitive nature of sewing tasks increases their vulnerability to Musculoskeletal Disorders (MSDs), one of the most common occupational injuries. This study aims to evaluate the major risk factors for MSDs among sewing machine operators in Bangladesh, addressing the lack of ergonomic research in this sector. Key risk factors were identified using chi-square tests. Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) were applied to determine ergonomic risk exposure. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) ranked body areas based on total discomfort scores. Alarmingly, 80.72% of workers reported MSDs. The study found significant correlations between musculoskeletal issues and factors such as marital status, BMI, occupational stress, and job satisfaction. RULA and REBA results highlighted the urgent need to address ergonomic concerns. CMDQ findings showed the neck, right shoulder, and lower back as the most affected regions. The authors suggest that these insights will help employers create ergonomic workplaces, thereby improving worker health, mental well-being, and organizational productivity.