Aims To investigate the global prevalence, contributing factors and impact of work-related musculoskeletal disorders (WRMD), and ergonomics interventions and education, among otolaryngologists who perform endoscopic ear surgery (EES). Methodology A 58-item electronic survey was internationally distributed between September 2024 and May 2025. Data was collected regarding demographics, health and lifestyle, professional training, surgical practices, WRMD, ergonomics training and interventions. Results There were 284 respondents from 49 countries who met inclusion criteria. Respondents were predominantly male (68.1%), had an endomorph somatotype (34.3%) and were consultant/attending otolaryngologists (85.8%). There was a lifetime prevalence of WRMD of 73.0%, 12-month prevalence of 61.8% and 7-day prevalence of 37.7%, most commonly affecting the right neck (72.2%), left neck (71.4%), right shoulder (61.1%) and left shoulder (58.7%). EES was the predominant technique (> 75% of the time) for 28.4% of respondents. Surgeons who performed predominantly EES perceived less WRMD compared to respondents who performed predominantly microscopic surgery (OR 2.83 [95% CI 1.39-5.57], p = 0.004), however there was no difference in the rates of WRMD between these groups. Female surgeons experienced increased odds of developing WRMD (OR 7.71 [95% CI 1.03-57.93], p = 0.047). Approximately one-third (34.8%) of respondents had implemented ergonomics interventions and 17.2% had received ergonomics training. Conclusion There is a high global prevalence of WRMD among otolaryngologists who perform EES, despite the theoretical ergonomic benefit for the neck compared to microscopic surgery. There is an important need to develop surgical education and implement interventions to improve workplace ergonomics.