Objectives: The psychophysical demands of playing a musical instrument at a professional level pose significant challenges to the musculoskeletal system. Maintaining a position adapted to the instrument for long hours, every day and for many years may result in future postural abnormalities and chronic health problems. This study evaluated the 3-dimensional spinal and pelvic posture of professional saxophone players compared to non-musician controls Material and Methods: The study included 60 men aged 20–30 years: 30 professional saxophone players with an average playing experience of mean (M) ± standard deviation (SD) 12.57±2.06 years (the study group) and 30 healthy non-musicians (the control group). Sagittal and frontal spinal posture was assessed using the DIERS formetric III 4D system. Statistical analysis was performed using Student’s t-test for independent samples, the Mann-Whitney U test, and Pearson’s χ² test. Results: The professional saxophonists had significantly lower kyphotic angle ICT-ITL (cervicotho- racic and thoracolumbar inflection points) max values compared to the control group (p < 0.001), indicating a tendency toward a flatter physiological thoracic curve. Additionally, reduced thoracic kyphosis (hypokyphosis) was more frequently observed in the study group (p = 0.049). No significant differences between the groups were found regarding frontal plane parameters, such as lateral deviation or pelvic obliquity (p > 0.05). Conclusions: While professional saxophone playing does not alter the direction of spinal deviations, it significantly reduces the thoracic kyphosis angle, predisposing musicians to hypokyphosis. These findings highlight the need for specialised postural training and preventive rehabilitation strategies tailored specifically to the ergonomic demands of saxophone performance. Int J Occup Med Environ Health. 2026;39(4)