Background Musculoskeletal pain is common in the general population and constitutes a major public health problem. A large proportion of these conditions may be work related. This study aimed to explore the relative importance of physical, psychosocial and personal factors, for musculoskeletal single- and multisite pain, among women in ordinary professions with a broad variety of occupational exposures. Methods A cohort of 1115 women responded to a questionnaire of ergonomic, psychosocial, personal and life-style factors, and musculoskeletal pain (based on frequency and intensity of complaints in nine anatomical sites), at baseline and at follow-up (mean 28 months later). Sum-scores of ergonomic- and psychosocial factors were created. The importance of the exposures at baseline for multisite pain (≥four pain-sites) at follow-up were estimated using ordinal regression. Multi-exposure Poisson regression models of exposures at baseline were used for outcomes of single-site pain at follow-up, in the neck, the shoulders, the hands, the lower back and the feet. Results High sum-scores of ergonomic- and psychosocial factors at baseline were of importance for multisite pain at follow-up, although the strongest risk factor was the presence of multisite pain at baseline. There was a large fluctuation in number of pain-sites between the two time-points, on the individual level. Eighteen percent of the study population reported multisite pain both at baseline and at follow-up, while only eleven percent did not report any pain, neither at baseline nor at follow-up. Among the single-site outcomes, a high sum-score of ergonomic factors was a risk factor of pain in the neck, the hands and the feet. A high sum-score of psychosocial factors was a risk factor of neck- and shoulder pain. The strongest risk factor was, however, pain in the actual anatomical site at baseline. Only a few of the personal and life-style factors were of importance for subsequent single- and multisite pain. Conclusions An overwhelming majority of the women in common occupations were affected by musculoskeletal pain. Both ergonomic- and psychosocial factors were predictive of single- and multisite pain. The findings points to the need of actions on individual, organizational and societal level.