The objective of this study was to describe and analyse the changes in working conditions and health among dairy farmers in Scania in southern Sweden during the period 1988-2002 by a repeat of a mail-in survey. Altogether, 83 % of the male and 90 % of the female dairy farmers reported some kind of symptoms in the musculoskeletal system during the 12 months prior to the 2002 questionnaire. This is an increase compared to the farmers in 1988. The highest significant changes were an increase of symptoms in the shoulder, neck and in the wrists/hands. The milkers reported most often incidental as well as persistent symptoms in the shoulders. The frequency of hip symptoms was significantly higher among those male milkers who had quit milking during the interim than for the active milkers in 1988. The milkers studied in 2002 had, on average, increased their working time per week, increased the number of cows milked as well as the use of more milking units. In 1988, almost all the milkers studied were working in tethering systems while in 2002 more than one quarter were working in loose-housing systems. The opinion among most of the farmers, both in 1988 and in 2002, regardless of age or sex, was that silage handling and the milking procedure were the most strenuous work operations. On the other hand, the milkers obtained their greatest pleasure from the actual milking job as well as from their work to promote the welfare of the animals. Unprofitability and great investment demands had a bearing on the retirement of milkers but, on the other hand, a high potential of the milkers could have continued 10-15 more years as dairy farmers if the work conditions had been better, e.g. associated with fewer health problems. Apart from the need for developing technical devices to facilitate the milking operation, further research is needed concerning the dairy farmers' well-being and quality of life, perceived stress, and leisure time activities and how these and similar factors influence the prevalence of musculoskeletal symptoms. Strategies for preventive and intervention measures must consider physical workplace factors as well as personal and lifestyle characteristics.