Objective smokeless tobacco (Madgha) wide used in upper Egypt, Sudan and many countries, it has effects on multi systems, respiratory system one of them, presented on spirometry. Patients and Methods A spirometry was performed as a routine standard investigation for 100 patients aged between 28 and 67 year-old; 86 men and 14 women, from Southern Egypt and Northern Sudan. Madgha is a chewable type of smokeless tobacco, one pinch = about 2 grams putted between lower lip and gum for about 15 minutes. Results spirometry result, normal (28%), mild obstruction (16%) moderate obstruction (26%) severe obstruction (30%). Conclusion There is a strong relation between increase of Madgha use and obstructive defect of pulmonary function.