<h2>ABSTRACT</h2><h3>Background</h3> Nursing is a high-risk occupation for work-related musculoskeletal disorders and many nursing students have a history of musculoskeletal symptoms. <h3>Aims</h3> To quantify (1) changes in exercise and musculoskeletal symptoms from pre-registration to 12-month registered nurses, and (2) the best predictor of severity of musculoskeletal symptoms from measures of the five physical fitness components and exercise participation. <h3>Methods</h3> In this longitudinal study, August 2013 to April 2015, 62 (55.9%) of 111 nursing students fitness tested completed questionnaires measuring nursing work history, exercise, and musculoskeletal symptoms at baseline and 12 months post-registration. <h3>Findings</h3> Nurses' exercise participation declined post-registration and 38.0% were overweight/obese. At 12 months post-registration, 76.0% experienced musculoskeletal symptoms, mainly affecting the low back, neck, and/or shoulders. Approximately 50% of symptoms were attributed partly/solely to work; yet few were reported to employers or prompted sick leave. For female nurses, increases in whole-body strength were positively associated with increases in whole-body musculoskeletal symptom severity; however, the multiple regression model contained unexplained variability. <h3>Discussion</h3> Many nursing students entered nursing with modifiable risk factors for work-related musculoskeletal disorders: overweight/obese, earlier musculoskeletal symptoms, and poor exercise habits. As registered nurses, they showed high lifetime and 12-month prevalence of musculoskeletal symptoms and declining exercise. Reporting musculoskeletal symptoms were undervalued. <h3>Conclusion(s)</h3> Inadequate exercise and high prevalence of musculoskeletal symptoms among novice registered nurses may contribute to/aggravate musculoskeletal disorders. Nurse leaders should understand the exercise habits and fitness of pre-registration and novice registered nurses to develop interventions towards improving health behaviours to reduce musculoskeletal disorder risk.