Work-related musculoskeletal disorders (MSDs) are leading causes of disability and productivity loss globally, yet registry-based evidence from low- and middle-income countries remains limited. The study analyzed compensated work-related MSDs claims reported to the Workers’ Compensation Fund (WCF) in Tanzania between 2016 and 2022 to identify patterns and associated risk factors. A registry-based cross-sectional design was conducted using de-identified WCF data on demographics, occupation, industry, diagnosis, and recorded workplace exposures. Modified Poisson regression was used to estimate associations between work-related MSDs and risk factors. Among the 243 workers with work-related MSDs whose claims were accepted and compensated, 84% had low back pain (LBP), predominantly males (90%) and middle-aged workers (mean age 41.6 years). Mining and quarrying accounted for 50% of the cases, with drivers and mobile plant operators being the most affected. Whole-body vibration (WBV) exposure and work in mining and quarrying were significant predictors of LBP (adjusted PR = 1.25; 95% CI: 1.061.49 and PR = 1.21; 95% CI: 1.01–1.44, respectively). These findings highlight WBV and mining work as significant risk factors of work-related MSDs and underscore the need for targeted interventions alongside enhanced health surveillance systems for exposure documentation.