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Background: India experiences a growing aging population and prioritizing the comprehension of respiratory health concerns among the elderly becomes crucial. Those in the elderly demographic residing in urban slums confront notable socioeconomic obstacles and encounter restricted healthcare accessibility, heightening their vulnerability to respiratory illnesses. Therefore, examining respiratory health in this specific urban context provides insights into how living conditions impact the health of vulnerable populations. Objectives: The present study aims to evaluate the occurrence of respiratory abnormalities among slum-dwelling elderly women and also to determine the concomitant factors responsible for respiratory abnormalities among them. Material and Methods: The study includes a total of 261 elderly women aged 60 years and above living in slum areas of Kolkata. The standard protocols were followed to collect spirometry and anthropometric data. Descriptive and inferential statistical analyses were performed to satisfy the study objectives. Results: The majority of the participants show forced vital capacity (FVC) and forced expiratory volume in one second (FEV0.1) below the predicted level, indicating the presence of mild-to-moderate respiratory abnormality. Chronic obstructive respiratory disease (COPD) was observed in 15.2% of elderly women, significantly higher than the national average. The study identified significant correlations between age and respiratory abnormalities. Factors such as overcrowded living conditions, the absence of a separate kitchen, and the use of certain cooking fuels increased the likelihood of COPD. Body fat percentage was found to be inversely related to FVC, FEV0.1, and COPD. Conclusion: The poor living conditions and a few other associated factors are indicative of developing respiratory problems among elderly individuals. As the global population ages, this study contributes valuable insights for public health strategies, emphasizing the need for tailored approaches to address the specific challenges faced by elderly women in urban slums in the megacity of Kolkata.