Background: Lower back pain (LBP) is a leading cause of disability and reduced quality of life globally. While numerous factors have been implicated in its aetiology, the role of anthropometric variables such as stature remains understudied, particularly in sub-Saharan African populations. This study investigates the relationship between stature and lower back pain among adults in Irrua, Edo State, Nigeria. Methods: A cross-sectional survey involving 410 adult participants was conducted using structured questionnaires and anthropometric measurements. Data collected included sociodemographic information, height, weight, body mass index (BMI), physical activity levels, occupational characteristics, and the presence and severity of LBP. Statistical analyses including Pearson correlation, chi-square tests, and multivariate logistic regression were used to assess associations and predictive relationships between stature and LBP. Results: The prevalence of LBP among participants was 43.4%. A statistically significant negative correlation was observed between stature and LBP occurrence (r = -0.184, p = 0.001), indicating that shorter individuals reported LBP more frequently. Pain severity was significantly higher among those in the lower stature category (<160 cm) (χ² = 14.2, p = 0.007). Multivariate analysis identified sedentary occupation, frequent lifting, physical inactivity, high BMI, and short stature as significant risk factors for LBP. Logistic regression confirmed stature as an independent predictor of LBP, with the odds of experiencing LBP decreasing by approximately 4% for every 1 cm increase in height (OR = 0.96, p = 0.006). Conclusion: Stature is a significant anthropometric predictor of lower back pain among adults in Irrua. Individuals of shorter height are more vulnerable to both the occurrence and severity of LBP, particularly when compounded by modifiable lifestyle and occupational risk factors. These findings underscore the need for height-sensitive ergonomic designs, preventive health screening, and policy interventions that incorporate anthropometric diversity into public health planning.