The possible association between entheseal changes and activity has been widely studied. However, many questions remain. This study aims to assess if occupation and physical activity influence the age at which entheseal changes appear in the iliac crest, retroauricular area, iliac tuberosity, ischial tuberosity and obturator foramen. Absence or presence of ossification exostosis and stress lesions was recorded in os coxae from 130 males (19 to 88 years old) from Lisbon and Coimbra identified skeletal collections. The individuals were divided into two groups, based upon to the recorded occupations: manual (n = 69) and non-manual (n = 61). The sample was also divided according to an osteological indicator of physical activity: the femur robusticity index (55 are robust and 54 are gracile femora). The individuals from manual and robust groups were considered to have had physically demanding occupations, while the non-manual and gracile groups represent individuals with less demanding activities. The asymmetry of entheseal changes between left and right sides of the same individuals was tested with a Chi-square test. And the influence of occupation and physical activities on the age of appearance of entheseal changes was tested using logistic regression. Statistically significant asymmetry was not found between left and right bones (p <0.05). However, for the logistic regression calculations, the only valid result was obtained for the ossification exostosis on the iliac crest for the measure of femoral robusticity. For the iliac crest, physical activity did not influence the appearance of ossification exostosis. It was not possible to obtain valid logistic regression models, probably due to the distribution of individuals in each occupational and robusticity category. Therefore, it was not possible to assess the influence of occupation and physical activity on the age at which entheseal changes appeared for retroauricular area, iliac tuberosity, ischial tuberosity and obturator foramen. Copyright © 2012 John Wiley & Sons, Ltd.