Musculoskeletal disorders of the limbs (MSDs) are the leading cause of occupational illness in France and across Europe. The pilot network for the epidemiological surveillance of MSDs, established by the French Institute for Public Health Surveillance in 2002 in the Pays de la Loire region, provides new insights into the prevalence of MSDs and their risk factors among the working population, particularly among older workers. Between 2002 and 2004, a sentinel network of 83 volunteer occupational physicians enabled the random selection of 3,710 employees aged 20 to 59 who were representative of the region’s workforce. The six main upper extremity MSDs were clinically diagnosed according to a rigorous protocol. Occupational exposure was assessed using a self-administered questionnaire focusing on biomechanical and psychosocial risk factors for MSDs. At least one of the six main MSDs was diagnosed during the clinical examination in 15% of women and 11% of men. Among employees aged 50 to 59, nearly 19% of men and 27% of women suffered from at least one of the six MSDs. Blue-collar workers are the most affected, regardless of age and gender, ahead of white-collar workers. Occupational exposure to MSD risk factors remains high among those aged 50–59, regardless of gender: 77% of male blue-collar workers and 72% of female blue-collar workers remain exposed to at least two MSD risk factors. The implications for MSD prevention and workplace retention are discussed. The high prevalence of MSDs among those aged 50–59, combined with significant biomechanical and psychosocial constraints, underscores the need for a comprehensive approach to MSD prevention in workplaces to reduce risk exposure and ensure the retention and/or return to work of employees suffering from MSDs. (R.A.)