Repetitive use of hand-held power tools is associated with work-related upper extremity musculoskeletal disorders. Using a pneumatic nutrunner, 21 men completed twelve 360 repetitive fastener-driving sessions on three joints (hard, soft and control) at slow and fast pace, and two different work:rest patterns. Handgrip force and perceived exertions were collected throughout each session. For the control joint, the mean grip force exerted was 39.6% of maximum voluntary exertion (MVE) whereas during hard and soft joint sessions it was 48.9% MVE and 56.9% MVE, respectively. Throughout each session, the grip force decreased, more while operating soft and hard joints as compared with the control joint (regression slope: -0.022 and -0.023, compared with -0.007 N/drive, respectively), suggesting considerable upper extremity muscular effort by participants during torque buildup. Fast work pace resulted in higher average grip forces by participants but a greater decrease in the force as the session progressed. Providing rest breaks reduced perceived exertions. The findings gain additional knowledge for assembly task design to possibly reduce the hand/arm injury risks for the operator. Practitioner Summary: Powered hand tools are widely used in assembly and manufacturing industries. However, the nature of their repetitive use on human operator biomechanical and perceptual responses is not fully understood. This study examined work-related risk factors such as joint torque, pace and work:rest ratios on powered hand tool performance.