Introduction: Growing evidence suggests that occupational exposure to carbon black may be a risk factor to the cardiovascular and respiratory systems. Objectives: To spotlight cardiopulmonary changes among workers exposed to carbon black, to find out different risk factors which may increase the health hazards and to determine the most effective intervention strategy to limit health hazards of carbon black exposure. Materials and Methods: A cross sectional study was done in carbon black factory in Borg Elarab , Alexandria. The studied group was subjected to a questionnaire including detailed occupational, present and past histories. General examination was done, blood pressure was measured in erect and supine positions and average was taken. Mean arterial blood pressure was calculated. Investigations were done including: CBC, pulmonary function testing (FVC and FEV1) and Plain chest x- ray. Results: the current study detected that DBP was higher among highly exposed group ( 80.7±9) compared to moderately exposed (77.6±9) and unexposed (76.5±8) (statistically significant ). Mean arterial blood pressure was higher among highly exposed (95±8.4) and moderately exposed (92.3±9) group compared to unexposed group (84.5±8.6) and also highly exposed departments compared to moderately exposed with significant difference . As regard FEV1 was higher among unexposed group (3.8±0.7) compared to moderately exposed (3.5±0.8) and highly exposed (3.4±0.9) with statistically significant difference (p < 0.05). Also FVC was higher among unexposed group (4.8±0.7) compared to moderately exposed group (4.6±0.9) which was slightly higher than highly exposed group (4.3±0.8) with statistically significant difference. Both % of FEV1/FVC and 
FVC/PVC were higher among unexposed group (84.6±7.6) and (89±7.6) compared to heavily exposed (77.6±9) and (85.3±9) and moderately exposed (80±5) and (87±7) respectively with statistically significant difference. As regard the effect of work duration and smoking index; statistically significant inverse correlation was detected between all pulmonary function tests (PFT) versus duration of exposure among highly exposed group. Among moderately exposed group there is a statistically significant inverse correlation between FVC, FEV1 and FVC/PVC but no significant correlation could be detected versus FEV1/FVC. Conclusion: Carbon black exposure plays an important role in deterioration of pulmonary functions and elevation of diastolic and mean arterial blood pressure. Smoking plays a synergistic effect together with carbon black in induction of pulmonary and blood pressure changes.