Background: Iron is the world's most commonly used metal and can usually be found with other elements in the form of steel. The frequently recorded health disorders between iron and steel industry workers includes: respiratory and skin problems as well as noise-related hearing impairment. Objectives: Study auditory and respiratory health disorders among exposed workers in an iron and steel factory in Sadat city, Menoufiya governorate and assess workplace environment in the same factory. Participants and Methods: One hundred and six occupationally exposed male workers in an iron and steel factory was chosen and matched for age, sex, residence, education, income and smoking habit with a control (non exposed) group. A predesigned questionnaire including personal and occupational data and some respiratory and auditory manifestations was filled. All participants were subjected to spirometric measurements and audiometry. Environmental study for noise, dust and fumes measurements was also done. Results: Environmental study revealed higher mean value of noise and lower mean values of dust and fumes than the standard levels. Exposed workers showed significant higher prevalence of respiratory and auditory manifestations, spirometric and auditory findings than controls. With increasing years of employment, deterioration of spirometric measurements and audiometric changes increase. Conclusion: From environmental measures, although dust and fume levels were lower than the PEL; there were early changes in the spirometric measurements in exposed workers. Working in iron and steel industry may be associated with higher prevalence of chest manifestations, hearing impairment, changes in the mean values of different spirometric measurements and noise induced hearing loss. Recommendations: Exclusion of individuals having any respiratory or auditory manifestations during pre-employment medical examination. For early detection of respiratory and auditory disorders, spirometry and audiometry should be included in the periodic medical examination. Accurate health records of workers, so, those at risk can be monitored, and/or pre-placed. Using personal protective equipments especially masks and ear muffles as well as prohibit smoking in the workplace. Keywords: iron and steel Workers, hearing loss, respiratory disorders