Introduction: Water polo is an aggressive, competitive aquatic game played by two teams of seven players with the intention to defeat the opposing team by scoring more goals which occasionally generate musculoskeletal pain and injury. Water polo incorporates swimming, treading, throwing the ball, in a volatile, dynamic aquatic domain which lends itself to a high degree of aggression and direct physical contact among opposing players. Aim: This study documented the prevalence of water polo related musculoskeletal pain among competitive adolescent male water polo players residing in Kwa-Zulu Natal, South Africa (n=100). Material and methods: Subjects completed a self-report musculoskeletal pain questionnaire, which gathered their demographical, epidemiological and exercise history over the last 12 months. The following descriptive statistics (mode, mean, frequency, percentages) and inferential statistics (chi-square set at a probability of 0.05) were employed to analyse the data. Results: Seventy-two of the cohort sustained musculoskeletal pain within the last 12 months (p< 0.001). The most prevalent anatomical sites that sustained water polo related musculoskeletal pain were; shoulder (51.04%), knees (23.95%) and vertebral column (17.71%) (p<0.0001). The predisposing mechanisms of producing this water polo related musculoskeletal pain were over-training (88.00%), rapid rotational movements (8.00%), collision with players (2.66%), and being struck with the ball (1.33%) (p<0.001). Conclusions: Competitive adolescent male water polo players residing in Kwa-Zulu Natal, South Africa experienced a high prevalence of water polo related shoulder, knee and vertebrae musculoskeletal pain.