Dust generated during the handling and processing of cotton causes ill health of ginning workers. The purpose of this study was to determine the prevalence of respiratory symptoms among cotton-ginning workers. This study involved 188 workers of 10 cotton-ginning factories. Forced vital capacity (FVC), peak expiratory flow rate (PEFR), and forced expiratory volume in 1 s (FEV1) declined significantly with increasing duration of exposure (p < .001) of the cotton-ginning workers. Results of a standard respirator medical evaluation questionnaire indicated that, depending on duration of exposure, 51%-71% of cotton-ginning workers suffered from chest tightness, 55%-62% experienced chest pain, while 33%-42% of the workers reported frequent cough. Blood tests of the workers showed higher values of erythrocyte sedimentation rate, eosinophils, and white blood cells when exposure was longer. Byssinosis symptoms were observed among the workers. We recommend regular periodical medical check-ups, compulsory use of personal protective equipment, and proper ventilation at the workplace.