Musculoskeletal disorders (MSDs) are considered as major public health problems. The purpose of this study was to determine the prevalence of MSDs in Azar cohort population in northwest of Iran. Azar cohort study is a state level of a national cohort project (PERSIAN) which began in 2014. All adults over 35 years old in Khamene city in East Azarbaijan province were recruited for the pilot phase of the Azar cohort. For the purpose of the current study, a total of 952 subjects age range of 35-70 who completed the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) questionnaire as supplementary were included. 299 subjects had MSDs and were introduced to the rheumatologist, only 237 of them referred for further assessment. 33.4% of subjects had MSDs within the past 7 days. The most frequent complaint was pain and the most common sites of complaints were knee, lumbar spine, and shoulder, respectively. Osteoarthritis was the most common rheumatic disease (53.2%) and the knee was the most common region affected (47.7%) followed by low back pain (28.2%). Osteoarthritis and knee osteoarthritis were present in 56.1 and 51.8% of females and 46.6 and 38.4% of males, respectively. Furthermore, low back pain was present in 32.9% of males and 26.2% of females. Peri-arthritis was more prevalent in males (12.3%), whilst fibromyalgia, psychologic pain, and heel spur were prevalent among females (9.1, 5.1, and 1.2%, respectively). Rheumatoid arthritis was observed in 1.4% of males and 1.8% of females, respectively. Prevalence of MSDs is very high in this area. Therefore, it calls for action by heath officials and professionals to plan for appropriate programs of prevention and management of MSDs in society.