Introduction/Purpose: Sonographers develop pain whilst scanning and may not consistently adhere to ergonomic recommendations. The aim was to quantify this within Australian sonography students and recent graduates and to determine whether a relationship exists between: (i) pain and failure to adhere to ergonomic recommendations; and (ii) theoretical and practical ergonomic education during university and clinical placement, and the adherence to recommendations. Methods: Online questionnaire distributed to Australian student sonographers and sonographers until two years post-graduation. Results: During scanning, 33/39(84.62%) experienced musculoskeletal pain, and 21/33 (63.64%) experienced pain less than 1.76 full-time equivalent (FTE) days during the two FTE week period. The majority, 37/39 (94.87%), were not consistently adhering to recommendations, with 25/37 (67.57%) only doing so for less than 2.1 FTE days during two FTE weeks. Failure to adhere to ergonomic recommendations and development of musculoskeletal scanning pain was positively correlated (r = 0.7 (P = 0.01)). All participants had received some form of ergonomic education. This education was theoretical and practical during university and clinical placement for 24/39 (61.54%); however, receiving this resulted in no difference for adherence to ergonomic recommendations. Qualitative data demonstrated high workloads, scanning patients with increased body habitus or limited mobility were potential barriers to adherence to ergonomic recommendations. Discussion: Ergonomic education occurs, yet a lack of knowledge and adherence to recommendations continues. Considerations for other potential barriers are required. Conclusion: Ensuring students adhere to ergonomic recommendations post-graduation and identifying relevant barriers within the clinical environment are important. Future research to investigate potential barriers around ergonomic adherence is suggested.