Textile industry workers are exposed to different hazards in the various sections of textile manufacturing. The major health problems associated with cotton dust are respiratory problems. Aims: this study was conducted to determine the prevalence and identify the determinants of respiratory health problems among textile workers in El–Beheira governorate. Design: A cross sectional descriptive study was adopted to carry out this study. The sample included 603 workers who were selected by proportional allocation technique from different departments and by systemic random sampling within the department. Data was collected using three tools (Textile companies' workers health profile, safety and health at work observational check list, Work place stress scale).Results: less than half (47.8%) of the workers had experience of 30 years or more (mean was 27.2 ± 6.6.). All workers reported that the personal protective equipment weren't available. Moreover, all workers mentioned that there are no health education programs. The highest prevalence of respiratory problems found among spinning workers followed by dyeing workers, weaving workers, and polyester staple fiber. Conclusion, The significant prevalence and associated factors of respiratory problems should alert the factory, governmental and non-governmental organizations working on Occupational Health and Safety. Recommendations: Periodic inspection of working environment by industrial hygienist through regular measurement of cotton dust concentration.