The effect of alternative keyboard design features on musculoskeletal discomfort was examined. The subjects consisted of 50 female clerical workers able to type 40 to 55 words per minute. The standard keyboard was referred to as Keyboard-A. The alternative keyboards were split into halves. The keyboard halves of Keyboard-C inclined laterally, with the keys arranged in a concave format. The keyboard halves of Keyboard-D were laterally inclined, while those of Keyboard-E were laterally inclined and rotated. When Keyboard-D was tested in the flat position, it was referred to as Keyboard-B. Two handed text entry tasks were performed in adjustable workstations over 3 days; on the first day, the standard keyboard was used. Musculoskeletal pain and fatigue were assessed by the subjects. Based on the number of keystrokes per hour, the overall performance was significantly poorer for Keyboard-C than for Keyboard-D or Keyboard-A. Although performance on Keyboard-C and Keyboard-E was significantly lower on day two than on day one, performance improved across the workday, improving overall by day three. No significant differences in the number of errors per hour were determined among the keyboards. In general, the different keyboard designs did not significantly affect musculoskeletal discomfort or fatigue levels. While physical discomfort increased across each workday and across the study period, and fatigue increased across each workday, discomfort and fatigue levels were generally low. The authors conclude that alternative keyboard usage only minimally affects performance, discomfort, and fatigue after a 2 day trial period.