Objective: The purpose of this study was to investigate the musculoskeletal diseases (MSDs) that occur in heavy industrial workers according to the occupational category, prevalence, environment, and number of physical therapy visits. Design: Retrospective cohort study. Methods: For this study, data was collected of workers who were engaged in heavy industry in Korea and who visited the company physicians and received physical therapy in 2016. Data was collected from 855 subjects and was analyzed. With the data collected, analysis of the type and prevalence of MSDs and the number of physical therapy visits that have occurred according to the occupational category and environment was performed. Results: The most common MSDs were lumbar sprains and spasms (31.1%), and shoulder sprain and spasm (19.4%). In addition, the most common type of MSDs according to the occupational category and environment (occupational type) were lumbar sprain and spasms in 11 occupations, including white collar workers, and in milling, inspection, crane operation, and finishing jobs, shoulder muscle sprain and strain were the most common disorders. Also, the prevalence of MSDs according to occupational category and environment (occupational type) was the highest in workers involved with welding, which was 29.7%. Conclusions: Through this study, the type and prevalence of MSDs according to the occupational category and environment of heavy industrial workers have been confirmed. Further studies are necessary to study the future types of the work patterns of industrial workers and to develop a system for preventing and managing MSDs that may occur.