Abstract Objective: To determine the association of musculoskeletal discomfort with the high heeled shoes related variables in females who use such footwear frequently. Methods: A cross sectional study was conducted on 174 female residents of Islamabad and Rawalpindi, for a time period stretching from July 1, 2018 to December 31, 2018. The participants aged between 18 and 55 years appeared as the frequent users of high heeled shoes. The Nordic Musculoskeletal Questionnaire (NMQ) and Numeric Pain Rating Scale (NPRS) were used as outcome measures to assess the musculoskeletal discomfort and a self-structured questionnaire was used to obtain information related to the high heeled shoes e.g. duration and frequency of high heeled shoe use. Data was analyzed using SPSS version 21. Results: The data analysis showed a positive association of shoulders’ discomfort with length of high heeled shoes used by women (p value= 0.03<0.05). Moreover, a positive association was also found between an occurrence of upper back discomfort and length of the heeled shoes (p value= 0.01<0.05). However, no significant association was found between pain intensity and length of the shoe’ heel, frequency and duration of high heeled shoe use. Conclusion: The shoulders’ and upper back discomfort in females who frequently used high heeled shoes was determined to be associated with the length of the heels in shoes. Keywords: Female, Heel, Musculoskeletal System, Pain, Shoes. Continuous...