This study aimed to estimate the prevalence of respiratory symptoms and to assess respiratory health risks associated with Particulate Matter (PM) exposure among the residents of Windhoek, Namibia. Objectives: To measure particulate pollution concentration in Windhoek through monitoring of particulate matter concentration and to identify any associations between particulate pollution, individual location, and respiratory health among the Windhoek resident’s. Methods: an adapted standardized self-administered questionnaire was used to collect respiratory health related data as well as previous exposure, while PM monitoring was done using the ASTM (American Standard Test Method) D1739 reference method. Results: A high prevalence was observed for cough (43%), breathlessness (25%), and asthma (11.2%). PM was found to be a significant risk factor for episodes of coughing and phlegm, while high PM exposure category had an increased odds ratio (OR) for episodes of phlegm and cough (OR: 2.5, 95% CI (95% confidence intervals): 0.8–8.0). No association was observed between location and respiratory health outcomes. Conclusions: The study found high levels of PM concentration across all Windhoek suburbs which were above the German, American, and Environmental Protection Agency (EPA). Enactment of legislation relating to the control and monitoring of PM related emissions at the point of generation is required at both a country and city level.