The quality of the soil, air, and water are significantly impacted by coal-fired thermal power plants (TPPs), which negatively affects the surrounding environment and human health. The current study's goals were to detect specific heavy metals in fly ash, air, water, and soil samples, as well as to evaluate the respiratory health of the community living close to the plant. Materials and Procedures In the current cross-sectional study, 3533 adult people from two strata within a 10-kilometer radius of the TPP in the Karnataka state's Udupi district participated. Semi-structured questionnaires, spirometry, environmental air monitoring with a DustTrak aerosol monitor, water samples, and soil samples were used to obtain the data. Results: The majority of the study's participants were over 45 years old (41.4 percent). There were 70.6 percent females and 0.39 percent transgender people. There were different respiratory issues in 4.3 percent of the population. According to bivariable logistic regression, participants aged 46–65 and >65 respectively had 2.91- and 4.42-times greater risks of respiratory disease than those aged 45 years. The results of multivariable logistic regression revealed a significant correlation between older age groups and subjects who had closed their windows while cooking (P 0.006). While the amounts of iron, manganese, and copper in the ground water samples were overly high, the levels of heavy metals in soil samples and particulate matter 2.5 were well within allowable limits. The results of this study have consequences for the formulation of policies that safeguard the environment and human health.