Dust exposure is one of the major risk factors for respiratory health in many workplaces, including coffee factories. The aim of this study was to assess the prevalence of respiratory symptoms and lung function reduction among workers in Ethiopian primary coffee processing factories, compared to a control group of workers. A total of 115 coffee workers and 110 water bottling workers were involved in this study, from 12 coffee and 3 water bottling factories in Ethiopia, respectively. The chronic respiratory symptoms were assessed using a structured interview, using a standardized questionnaire adopted from the American Thoracic Society (ATS). The lung function tests were performed according to the ATS recommendation for spirometry. The coffee workers had a significantly higher prevalence of coughing, coughing with sputum, breathlessness, work-related shortness of breath, and wheezing compared with the controls. The prevalence ratio of work-related shortness of breath (PR = 3.7, 95% CI: 1.6–8.7) and wheezing (PR = 3.3, 95% CI: 1.3–8.4) was significantly higher for the coffee workers compared to the controls. The coffee workers in the age groups 28–39 years and ≥40 years, had a significantly lower forced vital capacity and forced expiratory volume in 1 s compared to the controls in the similar age groups. The findings indicated the need for longitudinal studies on the possible effect of coffee dust on respiratory health of coffee production workers.