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We shed light on the diverse conditions commonly encountered in the region, from the centuries\u2010old illnesses of tuberculosis, to contemporary problems such as lung complications from chemical warfare. We specifically highlighted unique aspects related to respiratory illnesses in the Middle East, for example, climate factors in the desert region, cultural habits, for example, water\u2010pipe smoking and disorders unique to the region, such as Beh\u00e7et's disease. Pulmonologists are also faced with the consequences of modernization, including large immigrant population and associated social and health issues, rising incidence of obesity and sleep apnoea, and drug\u2010resistant tuberculosis. 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