Objectives: Hip osteoarthritis (OA) and rotator cuff lesions (RCL) are major musculoskeletal disorders that cause chronic pain, reduced mobility, and work incapacity. While certain occupational groups have been studied, limited data exist on other physically demanding professions typically performed by women, such as healthcare, childcare, and hairdressing. This study examines the prevalence and occupational risks of hip OA and RCL in Germany. Material and Methods: A retrospective analysis was conducted using anonymized, large-scale, nationwide claims data (2016–2020). Individuals aged 18–65 years diagnosed with OA (International Classification of Diseases and Related Health Problems [ICD-10]: M16) or RCL (ICD-10: M75) were identified. Physically demanding occupational groups were classified according to the German Federal Employment Agency and compared to a propensity score-matched control group of office workers. Results: Between 2016 and 2020, the prevalence of hip OA increased from 1.8% to 1.9%, and RCL from 4.4% to 4.6%. Higher prevalence rates for RCL were found in exposed occupations (4.9%). Increased risks were observed in elderly care (OA: odds ratio[OR] = 1.33, RCL: OR = 1.49) and in health and nursing care (OA: OR = 1.33, RCL: OR = 1.27) compared to office workers with lower physical exposure. Restricting the analysis to women yielded similar effect estimates. Conclusions: The findings highlight an elevated occupational risk for hip OA and RCL in physically demanding professions such as nursing. Targeted prevention, ergonomic interventions, and early screening are essential to reducing work disability and improving long-term health outcomes. Int J Occup Med Environ Health. 2026;39(1)