Abstract The purpose of this study was to examine the outcome of accidents resulting in manual handling injuries (MHI) in relation to the disability caused. The Merseyside Accident Information Model (MAIM) was used to provide an event structure relating to accidents involving hospital treatment for 1504 people injured at work. Data was collected by interview; 1077 of these were followed up for details of subsequent sickness absence, return to work and impairment of normal activities. MHI accounted for 40% of the accidents and 80% of these required up to 4 weeks sickness absence. One in every five MHI cases required more than a month's absence from work. The profile of time lost was similar for MHI and non-MHI. Approximately 48% returned to work on reduced duties or changed their jobs. Over 10% required hospitalisation overnight as a result of the MHI. A large number took between 4 and 8 weeks to return to work, while four out of every 257 people failed to return to work. Underfoot accidents and age were significant predictors that disability would result from a manual handling accident.