Background: Garment industry in Egypt has been estimated in 2008 to be about 458 enterprises (employing 103,000 workers) representing 42.0% of the overall textile and garments industries, and 4.8% of the total private sector enterprises. Al-Mahalla Al-Kubra, which is the greatest city of El- Gharbia Governorate houses 263 (57.4%) of these enterprises (employing 12,209 workers). The occupational exposure to physical hazards may adversely affect workers' comfort, health, performance and productivity. Objective(s): This study was designed to assess the relation between work stresses imposed by exposure to physical hazards and productivity in Garment industry in that city. Methods: This was a cross-sectional study that was conducted in five garment enterprises in Al-Mahalla Al-Kobra city. The five enterprises included two public and three private sector units, representing 12% of the total number of garments' workers within the city.  The collected data included data from records, workers' and employers' or managers' interview, and the results of the physical hazards' assessments. Since it was difficult to calculate the workers' productivities directly from enterprises' records, the productivities of the workers were computed as follows:  % of productivity = Standard workers' productivity (100%) - % deficiency in his or her productivity from the standard. Results: The higher percent productivity reported in the Private sector enterprises (86.5%, 86.5% and 100% in C, D, and E enterprises respectively) than in the Public (71.5% and 54.7% in A and B enterprises respectively) may be attributed to the production payment regimen common in the former than in the latter. The workers in the Private-sector enterprises were keen to achieve the greatest production to get maximum payment. This may also interpret the considerably higher workers' attendance (less absenteeism) among Private-sector workers than in the Public-sector ones.                                                                       Conclusions: The deleterious effects of workers' exposure to physical hazards; heat, noise and vibration, and improper illumination on their productivity are clearly demonstrated in the present study. Attention should be directed towards the control of these hazards and improving the work environment of the garment industry in Egypt, particularly in the Public sector enterprises.