This study surveyed ergonomic issues in 308 Native American flute players. It also correlated the physical measurements of a subgroup of 33 participants with the largest flute they found comfortable. The data was used to derive a predictive formula for the largest comfortable flute based on physical measurements. The median age of players was 63 years with a mean of 6.9 years playing Native American flute. Females reported significantly less time playing the instrument (p = .004), but significantly faster self-reported progress rates (p = .001). Physical discomfort was experienced by 47-64% of players at least some of the time. Over 10% of players reported moderate discomfort on an average basis. Females report significantly higher maximum and average physical discomfort than males (p < .001 and p = .015, respectively). Height, arm span, hand span, and reported length of time playing and experience level all correlated with the largest flute that the player found comfortable. Multivariate coefficient analysis on those factors yielded a formula with a strong correlation to the largest comfortable flute (r = +.650). However, the formula does not have sufficient correlation to have value in predicting flute design. Customization of Native American flutes with the goal of improving ergonomics is proposed as a worthwhile goal.