Background: Gastroesophageal reflux disease (GERD) is linked to dysfunction through mechanisms like microaspiration and vagally mediated reflexes. Understanding this relationship is crucial for improving diagnosis and management strategies. Methodology: A cross-sectional study was conducted at Khalifa Gul Nawaz Teaching Hospital, Bannu Medical College, Bannu, Pakistan; 80 participants with clinically confirmed GERD assessed its impact on pulmonary function. Data were collected using symptom questionnaires, pulmonary function tests (PFTs), esophageal pH monitoring, and bronchoscopy. Quality of life was measured using GERD-HRQL and SGRQ scores. Results: GERD severity correlated significantly with impaired pulmonary function (FEV1: 78.4±12.2%, FVC: 81.3±10.5%; p = 0.03). Microaspiration (35%) and laryngeal symptoms, such as chronic cough (50%) and throat clearing (60%), were prevalent. GERD treatment alleviated respiratory symptoms in 72.5% of participants (p = 0.001). Quality of life scores highlighted the systemic burden of GERD on respiratory health. Conclusion: GERD significantly impacts pulmonary function and quality of life. Early diagnosis and integrated care are essential for managing GERD-related respiratory dysfunction.