Otolaryngology-Head & Neck Surgery (OHNS) presents significant ergonomic challenges due to repetitive fine motor tasks, frequent use of headlights and loupe magnification, and the need to operate in confined spaces. However, the experience of female surgeons in this field remains underexplored. This narrative review examines the prevalence, severity, and risk factors of work-related musculoskeletal (MSK) symptoms among female otolaryngologists, as well as potential interventions. MSK pain is common among otolaryngologists, with female surgeons often disproportionately affected. Contributing intrinsic factors to ergonomic challenges include anthropomorphic differences such as grip strength and the additional challenges posed by pregnancy. Extrinsic factors further exacerbate these issues, with surgical tools and operating room environments that are not optimized for diverse user needs and a lack of gender-specific ergonomic training. Despite the high prevalence of MSK symptoms, female ergonomic awareness and education within OHNS remain limited. Addressing these issues requires early integration of ergonomic education in training, inclusive research on gender-specific needs, and collaboration with industry partners to develop tools and environments that accommodate diverse physical characteristics. These efforts are crucial for improving the well-being, performance, and representation of women in OHNS.