Objective: To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan. Study Design: Cross-sectional survey. Place and Duration of Study: Karachi, Pakistan, from October to December 2009. Methodology: Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry. Results: Out of 372 participants, 29 (7.8%) workers had chronic bronchitis (4, 9.1% aged ≥ 40 years) and 25 (6.7%) had COPD (12, 27.2% aged ≥ 40 years). Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe self-perceived dust exposure at work, ≥ 10 pack years of smoking, uneducated, longer duration of work (≥ 11 years), and ever smokers were more likely to have chronic bronchitis or COPD. In the multivariate analyses, severe self-perceived dust exposure at work (AOR = 7.4; 95% CI: 1.9, 28.0), family history of respiratory illness/symptoms (AOR = 4.8; 95% CI: 1.1, 20.9) and lack of education (AOR = 4.2; 95% CI: 1.1, 16.9) were significant predictors of chronic bronchitis. Duration of work ≥ 11 years (AOR = 5.5; 95% CI: 1.5, 19.7) and pack years of smoking ≥ 10 years (AOR = 3.5; 95% CI: 1.1, 11.7) were strong predictors for COPD. Conclusion: There is a high frequency of chronic bronchitis and COPD among textile workers. Multiple important predictors for prevention are identified.