The objective of this study was to identify risk factors for back pain among health care workers of Saudi Aramco. A validated questionnaire was used to collect information on back pain in the last 12 months as well as relevant risk factors among health care workers at a single Saudi Aramco health care facility. Completed responses were received from 964 of 3,295 workers. Three significant predictors for the presence of back pain were identified: female gender (odds ratio [OR] = 1.9, 95% confidence interval [CI] = 1.3-2.7), Saudi nationality (OR = 2.3, 95% CI = 1.4-3.9), and working as a surgeon (OR = 5.4, 95% CI = 1.4-21.5). Educational level was of borderline significance (OR = 1.6, 95% CI = 0.98-2.7). An interaction between gender and race was identified, with Saudi females being at particularly high risk of reporting back pain (OR = 3.9, 95% CI = 1.8-8.5). Gender, occupation, and nationality were identified as risk factors for back pain, and a particularly high risk was seen among female Saudis health care workers in Saudi Aramco. Nationality may be important because of cultural difference between groups, but also because of differences in benefits available.