Objectives This study aimed to investigate the association between the methods used to generate radiology reports and the prevalence of musculoskeletal symptoms among radiologists. Additionally, we investigated the factors associated with the use of such methods. Methods An online survey was sent to radiologists practicing in hospitals in the Eastern Province of Saudi Arabia. The survey addressed demographic characteristics, work environment, and methods used to generate radiology reports and included an evaluation of musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. Results were analyzed descriptively using the Chi-square test and logistic regression analysis. Results The survey was completed by 198 radiologists (111 men and 87 women), including residents (40.9%), specialists (27.3%), and consultants (31.8%). Most participants (71.2%) were aged below 40 years. In total, 140 (70.7%) participants had experienced musculoskeletal symptoms in the week preceding the survey. The most popular method used to generate radiology reports was typing using a keyboard, with 64.1% of participants using this method, followed by a handheld dictation device (49.5%). Radiologists with limited years of practice more frequently generated reports via keyboard typing, particularly those with <1-year of experience (35.8%). A multivariable logistic regression analysis revealed that radiologists who used handheld dictation devices were at higher risk of developing musculoskeletal symptoms. Conclusions Musculoskeletal symptoms are common among radiologists. Radiologists who use handheld dictation devices were particularly likely to report experiencing musculoskeletal symptoms. These devices were less commonly used among radiologists with fewer years of experience.