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Aim: To estimate the incidence of musculoskeletal pain and rheumatic disorders in a Bangladeshi rural community. Methods: This study was conducted in six villages near Dhaka from January 2001 to June 2002. Door-to-door case finding by interviewers was followed by interviewing and examination of positive respondents by trained doctors. The respondents with inflammatory arthropathies were reviewed 5 years later, in December 2006. Results: Four hundred and forty-one (M = 163, F = 278) out of 2685 adults (M = 1324, F = 1361) developed new musculoskeletal pain yielding an incidence rates of 10.9/100 person-years (PY) (M = 8.2, F = 13.6). The incidence was highest in the 35–44-year age group in both genders. It was highest in housewives, followed by weavers and cultivators. The spine (7.5/100 PY) was the most common affected part followed by knees (6.5), shoulder (6.2) and neck (6.2). The most common cause of new musculoskeletal pain was non-specific low back pain, followed by fibromyalgia and knee osteoarthritis. Forty-one subjects (M = 17, F = 24) developed inflammatory joint or spinal pain (1000/100,000 PY). The incidence of rheumatoid arthritis, combined spondyloarthropothies, ankylosing spondylitis, reactive arthropathy and psoriatic arthritis were 120 (M = 101, F = 147), 150 (M = 252, F = 49), 75 (M = 151, F = 0), 50 (M = 101, F = 0) and 25 (M = 0, F = 49) per 100,000 PY, respectively. Thirty-one cases had undiagnosed arthropathies (770/100,000 PY). Seven were unavailable in December, 2006 and one died. The remaining 23 were symptom-free. Conclusions: The incidence of musculoskeletal pain and rheumatic disorders is considerable in this Bangladeshi rural community. Common incident disorders are non-specific low back pain, fibromyalgia and osteoarthritis of knees. Inflammatory arthropathies are not common. The majority of undiagnosed arthopathies undergo spontaneous lasting remission. [ABSTRACT FROM AUTHOR]