Background: Heavy vehicle drivers (HVDs) are at risk for musculoskeletal disorders, including Upper Cross Syndrome (UCS), due to prolonged sitting and repetitive tasks. UCS is characterized by muscle imbalances in the neck, shoulders, and upper back, leading to pain and functional impairment.Objective: This study aimed to assess the prevalence of UCS among HVDs and identify contributing factors such as working hours and pain intensity.Methods: A cross-sectional study was conducted from March 2024 to August 2024, involving 212 male HVDs aged 25-55 years, working for over a year, and experiencing neck and back pain for more than three months. Exclusion criteria included recent spinal trauma or deformities. Data were collected using the Numeric Pain Rating Scale (NPRS) and Neck Disability Index (NDI) and analyzed using SPSS version 25. Chi-square tests and linear regression were applied.Results: UCS was prevalent in 26.4% of drivers. A significant relationship was found between pain intensity and disability (χ² = 170.126, p = 0.000). Most drivers (66.9%) were aged 25-35 years, and 30.2% reported very mild pain.Conclusion: UCS is significantly prevalent among HVDs, with long working hours and poor ergonomics contributing to its onset.