ObjectiveTo investigate the prevalence of neck pain among video display terminal (VDT) workers in Shenzhen and to explore its association with cervical spine abnormalities shown by digital radiography (DR), prolonged sitting, and other potential influencing factors.MethodsFrom June to December 2022, a total of 626 VDT workers undergoing occupational health examinations at an occupational disease prevention and treatment institute in Shenzhen were studied by cluster sampling. Their neck pain status was surveyed, and cervical spine abnormalities were assessed via DR. Multivariate logistic regression model was employed to analyze potential risk factors for neck pain.ResultsThe prevalence of neck pain among these VDT workers was 48.88% (306), while the detection rate of cervical spine abnormalities on DR was 67.57% (423). There was no significant association between DR abnormalities and neck pain (P > 0.05). Multivariate logistic regression analysis indicated that, compared to male workers, those with≤5 years of work experience, and those with a junior high school education or lower, female workers, those with > 15 years of experience, and those with a technical secondary school or high school education or above had higher risks of neck pain (OR = 1.99 to 3.68). Compared to those working less than 40 hours per week, the risk of neck pain increased to 2.13 times and 3.03 times among those working 40 to 48 hours and≥56 hours per week, respectively. Compared to those with an average daily sitting duration of less than 5 hours, those sitting for more than 5 hours daily had a 1.95 to 3.45 times higher risk of neck pain. In contrast, VDT workers who exercised had a lower risk of neck pain than those who did not (OR = 0.63). All differences were statistically significant (all P < 0.05).ConclusionsThe prevalence of neck pain and the detection rate of cervical spine abnormalities on DR were both high among VDT workers. Shortening the work time and moderate exercise are beneficial to reducing the incidence of neck pain.