This study focused to evaluate effect of cotton dust and PM2.5 on health of workers of textile sector in Punjab. Prevalence of Chronic Obstructive Pulmonary Disease (COPD) was estimated in this study. This cross sectional study has also shown reduced pulmonary function in association to workplace exposure to cotton dust and PM2.5. Subjects with cough, phlegm, chronic bronchitis and occupation related wheeze had significantly impaired pulmonary function indices. This study also indicates additive effect of smoking with cotton dust and PM2.5 resulting into decline in lung function indices. Workers in stitching section, with prolonged duration of work, were more inclined to developing one or more of the respiratory disorders. In order to control occupational pulmonary diseases in the textile sector, effective control measures pertaining to dusts, repeated awareness of workers and staff on the issues of workplace hazards, and continuous health surveillance and monitoring programs is suggested and needed to be implemented. The utilization of proper personal protective equipment for workers at workplace is mandatory. Ventilation in the workplace, capacity building about workplace hazards and periodic medical check-up of workers in cotton processing facilities are effective tools to workplace exposure.