Abstract This paper reviews the current state of the relationship between computer keyboard use and the development of cumulative trauma disorders [CTDs] as found in the literature. Alternative keyboard designs using biomechanical evaluation methods as justification for their use are also reviewed. Critical factors such as the repetitiveness of the keyboarding task, the tendency of users to type with excessive force and forcing users to maintain prolonged awkward and static postures are discussed in relation to CTD development. Suggestions for future research into this area and possible keyboard substitutes are also reviewed. Relevance to industry The increasing incidence of cumulative trauma disorders (CTDs) in the workplace has led to a search for possible contributing factors and ergonomic interventions. The computer keyboard input device has received much attention in the past and is believed by many to be a prime factor in the etiology of CTD occurrence. This paper reviews the scientific literature published thus far that explores the relationship between CTD development and keyboard use in the service industries.