The purpose of this study was to determine the incidence of upper extremity discomfort among piano majors at seven Philadelphia-area music schools. A questionnaire was distributed to 232 students, and a 31% return rate was obtained. Thirty (42%) of the 71 respondents reported experiencing discomfort that lasted more than 1 week, and 41 (58%) of the respondents reported experiencing little or no discomfort. Twenty-six (87%) of the students with discomfort suspended practice for a period of time or made adjustments at the piano. Pain/aching was the predominant discomfort reported among students. Students experienced their discomforts most frequently in the hand (49% of respondents), the forearm (19% of respondents), and the wrist (16% of respondents). The majority of students reported an impaired ability to play the piano that lasted for 6 months or less. Further research is needed to verify the scope of the problem among student pianists and to substantiate the numerous causes of discomfort that were uncovered in this study. This occupational group could benefit from the knowledge and skills of occupational therapists in the area of occupational performance and physical function.