ABSTRACT Rapid urbanization and increasing construction activities have contributed to growing concerns regarding ambient particulate pollution and its potential implications for public health in developing cities. This study assessed the spatial distribution of cement-dust-related pollutants and examined respiratory health indicators in Enugu Metropolis, southeastern Nigeria. Ambient air samples were collected from twenty-two residential estates between March and September 2023 using a MiniVol portable air sampler and a Bosean multi-gas detector. Concentrations of PM?.?, PM??, SO?, and cement-associated oxides, including silica (SiO?), iron oxide (Fe?O?), aluminum oxide (Al?O?), magnesium oxide (MgO), potassium oxide (K?O), and sodium oxide (Na?O), were determined. Geographic Information System (GIS) interpolation techniques were employed to characterize spatial distribution patterns, while tuberculosis (TB) records obtained from the Enugu State Ministry of Health were used as respiratory health indicators at the Local Government Area (LGA) level. Results showed mean PM?.? and PM?? concentrations of 26.59 µg m?³ and 34.41 µg m?³, respectively. PM?? concentrations generally complied with international and national standards, whereas PM?.? concentrations slightly exceeded World Health Organization guideline values at selected locations. GIS analyses revealed localized pollutant hotspots around Heliu Estate, Harmony Estate, Fidelity Estate, Goshen Estate, Jubilee Estate, and Sunrise Estate, suggesting the influence of construction activities, traffic emissions, and dust resuspension. Health records indicated a total of 390 reported tuberculosis cases within Enugu Urban during 2023, with the highest burden occurring in Enugu West Local Government Area. Because environmental and health datasets were available at different spatial scales, the study was designed as a preliminary ecological assessment rather than a causal epidemiological investigation. Consequently, direct exposure-response relationships could not be established. Nevertheless, the findings provide valuable baseline information on urban air quality and respiratory health indicators and highlight the need for integrated environmental-health monitoring systems, improved dust-control measures, and sustainable urban planning in rapidly developing cities.