Aluminium oxide (Al 2 O 3 ) and titanium dioxide (TiO 2 ) nanoparticles (NPs) have been widely used in nanotechnology-based products. Recently, researchers and the public have raised concerns about the adverse effects of these NPs in biological systems, particularly in humans. The aim of this study was to investigate the possible adverse effects of these two common metal oxide NPs on human lung epithelium cells (A549) and to investigate NP size-dependent effects on these cells, considering both the primary and hydrodynamic particle size. NPs were found to inhibit cell viability and proliferation at the highest concentration level (10 mg/mL) included in this study, as measured by a clonogenic assay. Moreover, cell viability, proliferation and metabolism were impaired to a greater extent by the smaller NPs (5 nm TiO 2 and 10 nm Al 2 O 3 ) relative to the larger particles (200 nm TiO 2 and 50 nm Al 2 O 3 ) included in this study, as measured by cell proliferation and metabolism. Notably, the observed cytotoxic effects correlated to the primary size, rather than the hydrodynamic size. Similarly, NP cytotoxicity was found to be correlated with the NP surface area. These findings highlight the importance of including primary size and surface area information in NP characterisation in cytotoxicity studies.