Objective: To determine the influence of work-related risk factors by gender on long-term sickness absence with musculoskeletal diagnoses (LSM). Methods: Data from the Oslo Health Study were linked to the historical event database of Statistics Norway. Eight thousand three hundred thirty-three participants were followed from 2001 through 2005. Generalized linear models were used to compute risk differences for LSM. Results: In total, 12.6% of the women and 8.8% of the men experienced at least one LSM. Statistically, significant LSM risk increases between 0.039 and 0.086 in association with work environment were found for heavy physical work, low job control (men only), low support from superior (women only), and having shift/night work (men only). Conclusions: Women exhibited a higher LSM risk, but the associations with job exposures were stronger for men. This should be addressed when occupational health services give advice on preventive measures.