Exposure to metal dust is a significant occupational hazard for foundry workers, which may result in DNA damage, lipid peroxidation, and organ toxicity. This study aimed to investigate exposure to potentially toxic metals and oxidative stress indices and assess the health risk of occupational exposure to metal dust among foundry workers. This study utilized a case-control study with 60 male exposed workers and 30 male controls. Environmental and biological exposures to a cocktail of metals were examined by measuring the concentration of Aluminum (Al), Zinc (Zn), Copper (Cu), Cadmium (Cd), Nickel (Ni), and Chromium (Cr) in the air of the workplace, as well as in the blood of the exposed workers. Malondialdehyde (MDA), reduced blood glutathione (GSH) and urinary 8- hydroxydeoxy guanosine (8-OH-dG) were measured as biomarkers of oxidative stress. All air measurements were below the maximum allowable limits (MAL except for Al and Ni, which were above MAL according to ACGIH and NIOSH. Here are significantly elevated Blood Al, Zn, Cu, and Pb levels in exposed workers. Moreover, MDA and 8-OHdG levels significantly increased (P < 0.0001). In contrast, the mean level of GSH was reduced considerably in exposed workers compared to the control group (P < 0.0001). The MDA acts as a marker with the highest Area Under the Curve (AUC), enabling effective differentiation between the exposed and control subjects (AUC = 0.968; Sensitivity = 90%, Specificity = 100%; P < 0.0001), MDA may be used for follow up in exposed workers as an oxidative stress marker. Our study shows a significant increase in liver and kidney parameters as ALT AST, ALP, γGT, LDH, Urea and Uric acid with (P < 0.05). At the same time, there was a significant decrease in Hemoglobin in exposed workers (P < 0.05). Workers occupationally exposed to these metals for prolonged periods possessed higher metal levels in their bodies, which is associated with increased oxidative stress, which consequently causes DNA damage.