This review article provides a comprehensive overview of the respiratory toxicology of graphene-based nanomaterials (GBNs), including their exposure routes, metabolism, toxicity, and underlying mechanisms. GBNs, such as pristine graphene, graphene nanosheets (GNS), graphene oxide (GO), reduced graphene oxide (rGO), and modified graphene, are widely used in various industrial and biomedical applications due to their exceptional physicochemical properties. However, their widespread use has raised concerns about potential health risks, particularly in the respiratory system. GBNs can enter the human body through inhalation, ingestion, dermal penetration, injection, and implantation, and they tend to accumulate in the respiratory system. Inhaled GBNs can impair lung defenses and clearance, leading to the formation of granulomas and pulmonary fibrosis. The specific toxicity of the respiratory system caused by different GBNs, their influencing factors, and the underlying mechanisms are still relatively scarce. The review summarizes recent advances in the exposure, metabolism, toxicity, and potential mechanisms of various GBNs in the respiratory system. It highlights the importance of understanding the effects of GBNs on the respiratory system to ensure their safe use in various fields. The article also discusses the limitations of current research and suggests future directions for more comprehensive studies, including epidemiological data and in-depth animal experiments. Key findings include the significant impact of GBNs on oxidative stress, inflammatory response, genotoxicity, epigenetics, and apoptosis in both in vitro and in vivo studies. The toxicity of GBNs is influenced by factors such as size, lateral size, surface chemistry, and exposure duration. The review emphasizes the need for further research to establish exposure thresholds and health risk assessments for GBNs.This review article provides a comprehensive overview of the respiratory toxicology of graphene-based nanomaterials (GBNs), including their exposure routes, metabolism, toxicity, and underlying mechanisms. GBNs, such as pristine graphene, graphene nanosheets (GNS), graphene oxide (GO), reduced graphene oxide (rGO), and modified graphene, are widely used in various industrial and biomedical applications due to their exceptional physicochemical properties. However, their widespread use has raised concerns about potential health risks, particularly in the respiratory system. GBNs can enter the human body through inhalation, ingestion, dermal penetration, injection, and implantation, and they tend to accumulate in the respiratory system. Inhaled GBNs can impair lung defenses and clearance, leading to the formation of granulomas and pulmonary fibrosis. The specific toxicity of the respiratory system caused by different GBNs, their influencing factors, and the underlying mechanisms are still relatively scarce. The review summarizes recent advances in the exposure, metabolism, toxicity, and potential mechanisms of various GBNs in the respiratory system. It highlights the importance of understanding the effects of GBNs on the respiratory system to ensure their safe use in various fields. The article also discusses the limitations of current research and suggests future directions for more comprehensive studies, including epidemiological data and in-depth animal experiments. Key findings include the significant impact of GBNs on oxidative stress, inflammatory response, genotoxicity, epigenetics, and apoptosis in both in vitro and in vivo studies. The toxicity of GBNs is influenced by factors such as size, lateral size, surface chemistry, and exposure duration. The review emphasizes the need for further research to establish exposure thresholds and health risk assessments for GBNs.