Chronic exposure to granite rock-crushing dust is a major risk factor for respiratory problems in quarry workers. A cross-sectional study was conducted to determine the relationship between respirable dust exposure and respiratory health among granite quarry workers in Pulau Chondong, Kelantan. A purposive sampling method was used to choose the respondents based on the inclusive criteria which were male, aged between 18 to 60 years old, at least 1-year experience as a quarry worker and did not have any chronic lung diseases. The investigation included personal sampling for respirable dust, spirometry testing and a structured questionnaire on respiratory symptoms modified from the British Medical Research Council questionnaires. All the mean personal respirable dust in quarry sites were exceeding the permissible exposure limits (PEL) of 0.10 mg/m(3). Granite quarry workers reported the following respiratory symptoms: phlegm (46.0%), dyspnea (36.0 %), cough (32.0 %), and chest tightness (22.0 %). Only age was associated with chest tightness (adjusted odds ratio (aOR) = 1.56; 95% confidence interval (CI): 1.05, 2.33, p=0.028). The percentage of Force Expiratory Volume One Second per Forced Vital Capacity (%FEV1/FVC) was significantly lower as compared to the comparison group (t = -3.729, p<0.001). Forced Vital Capacity (FVC) was found to be significantly associated with smoking (adjusted b = -0.41, p=0.024) while age was negatively related to FEV1 (adjusted b =-0.03, p=0.003) and %FEV1/FVC (adjusted b = -0.42, p=0.004) respectively. No significant relationship was found between respirable dust exposure and respiratory symptoms or lung function (cough, p=0.470; phlegm, p=1.173; chest tightness, p=0.190; dyspnea, p=0.923; FVC, p=0.117; FEV1, p=0.399, %FEV1/FVC, p=0.195). More epidemiological and pathological research is needed better to understand the causes of respiratory problems in granite quarry workers and to develop effective prevention strategies.