Abstract: Objective To study the effectiveness of participatory training on prevention of occupational injury and musculoskeletal disorders (MSD) among workers. Methods During June 2008 and November 2010,1 825 workers in 30 factories were randomly divided into 2 groups. Totally 918 workers in intervention group received participatory training and 907 workers in control group received didactic training. The effectiveness of training programs was assessed by reviewing the injury statistics and MSD self-reporting at baseline one year after training. Results The follow-up rate was 59.1% one year after training. In the year after training,the incidence rates of injury in the intervention group reduced from 8.9% to 5.0% (P<0.01) in which that of male workers reduced from 11.3% to 5.5%(P<0.05). The incidence rates of injury for male workers and female workers in the control group also reduced, but the reduction was not statistically significant (P>0.05). The incidence rate of injury of female workers had no statistic significance. No significant changes in MSD prevalence rates for male workers and female workers were observed in both the intervention and control groups (P>0.05). Conclusion Participatory training is more effective to prevent injury for male workers than didactic training. Participatory training and didactic training could not reduce injury incidence rate for female workers and the MSD prevalence rate for male workers and female workers.