Street working environment condition particularly exposed to organic and inorganic dust and chronic inhalation of dust during street sweeping may associated with increases in respiratory health symptoms among street sweepers. However the street sweepers rarely used PPEs while exposed to high level of dust which may contribute to increases the prevalence’s of respiratory health symptoms. Few published studies have showed the chronic and lung function among street sweepers, but in Tanzania no published study about occupational respiratory health symptoms and associated factors among street sweepers. The objective of this study was to determine prevalence of respiratory health symptoms and associated factors among street sweepers in Ilala Municipality. Materials and Methods: Cross-sectional analytical study was designed 102 street sweepers as exposed group and 85 street vegetable sellers as unexposed group means less exposed to street sweeping dust from Ilala Municipality who worked one year and above and none smoker habit were studied, the respondent rate was 57.7%. Respiratory health symptoms and socio-demographic information were collected by using a modified American Thoracic Society respiratory symptoms questionnaire and level of utilization of PPEs were assessed by closed ended questions. Frequency distribution, Chi square test and logistic regression were used in data analysis. The prevalence of respiratory health symptoms was higher among exposed than unexposed group and the difference was statistically significant, for cough (54.9% vs 12.9%) phlegm (39.2 vs 7.1%), wheezing (32.4% vs 14.1%), nose irritating (35.8% vs 4.7%) and sneezing (63.7% vs 8.2). Street sweeping dust was the main associated factor to cough, phlegm, wheezing, nose irritating and wheezing utcomes, while age associated with cough and phlegm utcomes and duration of employment associated with cough outcomes among street sweepers, and the association was tatistically significant p<0.05. Availability and wearing of mouth/nose mask was reported 70.6% and 61.8%. General availability of PPEs 41.2% responded once after three months and wearing of PPEs 47.1% responded did not wear frequently because not available at any time which did not make them motivation of frequently wearing of PPEs during street sweeping. Respiratory health symptoms are associated with street sweeping dust exposure and the prevalence of respiratory health symptoms are higher among exposed group than unexposed group. The study has recommended that the appropriate and quality PPEs to be available and frequently wearing of PPE during street sweeping and medical intervention to be implemented for further diagnostic like sputum testing, chest x-ray and chest ultrasound for street sweepers.