The increasing prevalence of coal mine dust-related lung diseases in coal miners calls for urgent and meticulous scrutiny of airborne respirable coal mine dust (RCMD), specifically focusing on particles at the nano-level. This necessity is driven by expanding research, including the insights revealed in this paper, that establish the presence and significantly increased toxicity of nano-sized coal dust particles in contrast to their larger counterparts. This study presents an incontrovertible visual proof of these tiny particulates in samples collected from underground mines, utilizing advanced techniques such as scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS). The intricate elemental composition of nano-sized coal dust identified through EDS analysis reveals the presence of elements such as silica and iron, which are known to contribute to lung pathologies when inhaled over prolonged periods. The outcomes of the statistical analyses reveal significant relationships between particle size and elemental composition, highlighting that smaller particles tend to have higher carbon content, while larger particles exhibit increased concentrations of elements like silica and aluminum. These analyses underscore the complex interactions within nano-sized coal dust, providing critical insights into their behavior, transport, and health impacts. The nano-sized coal dust could invade the alveoli, carrying these toxic elements from where they are impossible to exhale. The revelation of nano-sized coal dust's existence and the associated health hazards necessitate their incorporation into the regulatory framework governing the coal mining industry. This study lays the groundwork for heightened protective measures for miners, urging the invention of state-of-the-art sampling instruments, comprehensive physicochemical profiling of RCMD nanoparticles, and the pursuit of groundbreaking remedies to neutralize their toxic impact. These findings advocate for a paradigm shift in how the coal mining industry views and handles particulate matter, proposing a re-evaluation of occupational health standards and a call to action for protecting coal miners worldwide.