In the realm of cement production, clinker-producing factories emerge as both energy and material-intensive entities, emitting a substantial array of primary pollutants into the environment compared to their non-clinker producing counterparts. Our study delves into Ethiopian clinker-producing cement factories, unraveling the concentration of primary pollutants and their repercussions on neighboring communities. Venturing beyond mere statistics, we meticulously measured particulate matter (PM2.5 and PM10) and gaseous emissions (CO2, N2O, SO2) at various units within the cement factories and in nearby residential areas. The findings reveal an ambient air quality riddled with concern; PM2.5 levels ranged from 137 to 814 μg/m3, PM10 from 195 to 886 μg/m3 within the cement factories, and PM2.5 (113 to 196 μg/m3) and PM10 (125 to 453 μg/m3) in the adjacent village. Alarmingly, these particulate matter emissions exceeded the limits set by Ethiopian ambient air quality guidelines (150 μg/m3). Unraveling the health implications, respiratory diseases were notably high among individuals aged 25 to 60, followed closely by those aged 6 to 24. In contrast, the age groups 0–5 and > 61 exhibited lesser susceptibility, as infants and the elderly spent more time at home, thus reducing exposure to emissions. Our study underscores the urgent need for legal measures, calling for the establishment of buffer zones between cement factories and settlements. This proactive step, if enforced, holds the promise of mitigating cement particulate emissions and safeguarding the well-being of communities residing in proximity to these industrial giants.