Objective (s): Carrying a heavy backpack may cause musculoskeletal disorders among students.. The objectives of this research were to determine the relationship between the way students carry the bags and musculoskeletal symptoms in Ilam, Iran.Methods: This study was performed in 16 girls’ primary schools. 244 students were randomly selected. The appropriate questionnaire was used to collect required data. Height and weight of students, the weight and model of their bags, and reported disorders related to the way they carried the bags were collected and analyzed.Results: About 4.5% of the primary students reported discomforts in their knees, 5.3% in back, 0.8% in elbows, 3.2% in neck, and 35.5% of them reported musculoskeletal discomfort in the shoulders. %22.5 of primary school students carried bags with %10-%15 of their body weight and students were experiencing the shoulder optosis.Conclusion: The most important disorders were shoulder optosis among students and many of them carried bags with weight more than 10% of their body weight. The way of carrying the bags can be considered as the most important risk factor for musculoskeletal problems among school students.The results of some studies showed that the way students carry school bags may increase the musculoskeletal complaints among school students