OBJECTIVE: To investigate whether height is associated with low back pain (LBP) and surgery, taking into account personal and socioeconomic risk factors in a general population. METHODS: In 2001, 13,680 participants of the Gazel cohort completed a self-reported questionnaire on LBP and surgery interventions. Three groups were compared according to their body height: no LBP (reference group, participants who declared they never had LBP), LBP without surgery (participants who ever had LBP but without surgery), and back surgery (participants who ever had surgery for LBP). Adjusted variables were sex, age, educational level, marital status, height, and body mass index. RESULTS: Mean height was significantly higher in men in the back surgery group than in the reference group and the LBP group. The proportion of surgically-treated LBP was higher for people whose height was > or =4th quartile (P < 0.0001). Being in the highest quartile for height was a stronger risk factor for surgery (adjusted odds ratio [OR(adj)] = 2.01, 95% confidence interval [95% CI] 1.61-2.51) than for LBP without surgery (OR(adj) = 1.29, 95% CI 1.18-1.40). CONCLUSION: The results suggest that being tall is a predictor for back surgery.