Chronic exposure of workers to powder containing crystalline silica (SiO₂) can lead to chronic lung diseases (lung cancer, silicosis, etc.). The aim of the study was to evaluate the exposure of Greek construction workers to SiO₂ and describe their pulmonary function. The study involved 86 outdoor and underground workers. Medical and professional history was obtained, and breath samples were collected at morning hours through a mask for the determination of SiO₂ levels. Pulmonary function tests, radiological examination and evaluation of radiographs were, also performed. During the examination of the pulmonary function, the majority of the workers were within normal range (61.4%) while the rest were diagnosed with mild (26.5%) and more severe impairment (7.2%). Working conditions (underground-outdoor) were statistically significantly related to the categorization of pulmonary function (p = 0.038). During radiological examination, the type of working conditions (underground-outdoor) were statistically significantly related to the categorization of these findings (p = 0.044). Of the 69 employees, 52 did not present findings (75.4%) and five (5) were diagnosed with findings specific to occupational diseases (7.2%). The environmental exposure to RCS (Respirable crystalline silica) was detected at 0,0125 mg/ m³ in the workplace, which is not beyond the legal limits. Underground workers with more than 15 years of exposure to SiO₂ are more likely to present chronic silicosis compared to the workers of outdoor activities.