In many of the textile industries, workers are largely exposed to cotton dust, which can leave workers with respiratory disorders. The aim of this study was to evaluate respiratory status of workers exposed to cotton dust in Arba Minch textile factory, Southern Ethiopia, 2017. A comparative cross sectional study was done and 51 workers exposed to cotton dust in the factory and 51 age and sex matched controls were investigated. Their lung function was measured with a pocket size digital Spirometer. A standardized questionnaire based on British Medical Research Council Questionnaire was used to assess respiratory system symptoms and use of personal protective devices. This study reveals that the percentage prevalence of cough, phlegm, wheeze, breathlessness and chest tightness was 64.7, 55, 39, 41 and 43% for exposed respondents, respectively and 25.5, 14, 8, 6 and 0% for control subjects, respectively. Lung function indices such as, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and forced mid expiratory flow between 25 and 75% of FVC (FEF25-75%) were higher in control respondents than in exposed respondents and the mean difference was found to be statistically significant (p<0.05) and the mean difference of predicted percentage values of FVC and FEV1 between the groups was found to be statistically significant (P<0.05). FEV1% was higher in the control group than in exposed group. Therefore, the factory management should provide personal protective devices (PPDs) to exposed employees and should train them. Key words: Cotton dust, textile, lung functions, respiratory symptoms.