Background and Aims Hand-arm vibration (HAV) is a major occupational hazard for jackhammer operators, and it causes Hand-Arm Vibration Syndrome (HAVS). This study aimed to assess the impact of HAV exposure on nerve conduction velocity (NCV) in jackhammer operators working in underground metal mines in India. Methods A cross-sectional study was conducted involving 30 participants, comprising 15 jackhammer operators and 15 unexposed mine workers. The groups were matched for age, gender, body mass index (BMI), and work experience to control for potential confounding variables. HAV exposure levels were measured by using the guideline stipulated by ISO 5349-1 (2001), and Electromyography was used to measure the NCV of the median nerve. Results Jackhammer operators exposed to HAV had significantly lower NCV in the median nerve compared to the unexposed group (p < 0.05). A strong inverse relationship was observed between lifetime vibration dose (ln(LVD)) and NCV (R2 > 0.75), indicating greater nerve damage with higher exposure. Conclusions Prolonged exposure to HAV significantly reduces NCV, suggesting nerve damage and the risk of HAVS. Implementing effective vibration control measures and conducting regular health check-ups are essential to safeguard the neurological health of underground jackhammer operators.