To determine their urinary toluene levels, to describe the workers’ hygiene behaviors and the prevalence of adverse health symptoms among automotive garage workers exposed to chemical substances. A cross-sectional descriptive study was conducted by interviewing among automotive garages located in the Nakhon Si Thammarat province, Thailand. During between 1 November 2020 and 31 December 2020. A total of 140 automotive garages workers were selected using a purposive sampling method. The questionnaire was conducted via face-to-face interview and the toluene was quantified using gas chromatography. Descriptive statistics were computed for the variables. Risk factors were evaluated using multiple logistic regression analysis. Adjusted odds ratio (ORadj) and 95% confidence interval (CI) were presented as statistically significant when the p value was < 0.05. The Mann–Whitney U test was used to compare the medians of continuous variables of the two groups. The prevalence of skin effects (60.71%); respiratory tract irritation (49.29%); nausea (46.43%); and dizziness (40.71%) was remarkable in the automotive garage workers. Several socio-demographic variables were significantly associated with increased skin effects, respiratory tract irritant, nausea, and dizziness. The median urinary toluene level of the automotive garage workers was 145 μg/L (range, 12.0-958.0 μg/L) which the median urinary levels and demographic characteristics, occupational lifestyle, personal protective equipment used, hygiene behavior, and adverse health symptoms had significantly significant different (p< 0.05).Urine is one of the most useful a sample for biomonitoring of occupational exposure to toluene. Personal hygiene is important for the automotive garage workers, and it should be emphasized in education programs.