Leg-length inequality was measured from radiographs at the level of the vertices of the femoral heads in 247 men and women aged 35–54 years. Of these, 53 had never had any low-back problem, but they had considerable variation in leg-length inequality (mean SD, 5.5 ± 4.1 mm; range, up to 20 mm). This group of symptom-free individuals did not differ from a group of 78 persons who had disabling low-back pain (LBP) during the previous 12 months (mean SD, 5.3 ± 4.0 mm; range, up to 17 mm). The adjusted relative risks (odds ratios) of having LBP ever and of disabling pain during the last 12 months were 0.78 (95% confidence interval, 0.43–1.17) and 1.02 (0.68–1.38), respectively, for an increase of 5 mm in leg-length inequality. The results from this study make an association between mild leg-length inequality and LBP questionable.