Background The rapid expansion of ceramic tile industry in Morbi, Gujarat, has led to increased occupational exposure to respirable dust, fine particulates and crystalline silica, raising respiratory health concerns among workers. Limited data exist linking these exposures with respiratory health in this sector. Methods A cross-sectional comparative study was conducted among 256 lifelong non-smoking workers in ceramic tile factories, comprising production workers and administrative staff. Personal air sampling quantified respirable dust, PM2.5, and crystalline silica across major process zones. Respiratory symptoms were assessed using a validated questionnaire, and spirometry was performed following ATS-ERS guidelines. Multivariate regression models were adjusted for age, exposure duration, and job role to assess lung function parameters. Results Workers experienced higher exposure to respirable dust (up to 29.36 mg/m³) and PM2.5 (up to 3.85 mg/m³) compared to administrative staff. Crystalline silica exceeded recommended limits in high-exposure zones. The prevalence of upper and lower respiratory symptoms was 23.8% and 20.6% among workers versus 11.9% and 9.0% among administrative staff. Obstructive lung patterns were identified in 19% of workers compared with 9% of administrative staff. Across process zones, lung function values (FVC, FEV₁, and FEF25-75) showed a consistent decline with increasing dust and PM2.5 exposure levels. Age, exposure duration, and job role independently predicted significant declines in workers’ lung function. Conclusion Ceramic tile workers experience excessive exposure to respirable dust, PM2.5, and crystalline silica, with observed patterns indicating early obstructive lung function impairment. Targeted dust control, regular monitoring, and periodic spirometric surveillance are urgently needed.