Chronic respiratory diseases affect hundreds of millions of people worldwide and are the third leading cause of mortality globally. Some of the most significant conditions include asthma, chronic obstructive pulmonary disease (COPD), lung cancer, and respiratory infections. Coffee, one of the most commonly consumed beverages worldwide, has been studied for its effects on respiratory health. Caffeine, its active component, has mild bronchodilator properties, but the impact of coffee consumption on respiratory diseases remains complex, with mixed evidence and sometimes contradictory findings. This chapter examines the associations between coffee consumption (as the primary dietary source of caffeine) and major respiratory diseases. Epidemiological studies suggest a potential protective effect of caffeine on asthma, with reduced disease risk and bronchodilation. However, data on COPD point to a possible increased risk of disease, likely influenced by smoking-related confounding. Regarding the relationship between coffee and lung cancer, some studies report an increased risk, especially in smokers, while others do not find this association. Coffee’s role in respiratory infections and persistent cough is less explored but may offer symptomatic relief. Some mechanisms underlying these associations involve adenosine receptor modulation, inflammation, oxidative stress, and interactions with smoking. Further research is needed to clarify the effects of caffeine and other coffee components in the prevention and management of respiratory diseases.