The study aimed to assess the possible influence of long-term human occupational exposure to cadmium and smoking cigarettes at the time of exposure on renal and liver functions in battery manufacturing. Methods: This cross-sectional study evaluated liver, kidney function, oxidative stress and lipid per oxidation among smoker and non smoker workers in battery manufacturing in Egypt. Multiple linear regression was conducted to investigate the association between cadmium exposure period and the serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), albumin, creatinine, uric acid (UA), urea, cu/zn superoxide dismutase (cu/zn SOD), glutathione reductase (GSH) in RBCs, malondialdehyde (MDA), hemoglobin and β2-microglobulin in urine, adjusting for smoking and the amount of cigarette smoked. Subjects were stratified into direct and indirect exposure according to their place of exposure. Results: our results show positive associations between exposure to cadmium and adverse effect on Hb, GSH, UA and GGT.