The need to maintain transport during a pandemic places transport workers at higher risk of infection and can have other effects on health and well-being. The aim of this study was to understand the current state of research on the impact of respiratory diseases on transport workers and to identify any existing evidence-based recommendations that can help mitigate the risks associated with these diseases in the transport industry. A scoping review was undertaken as per PRISMA guidelines. A search was conducted in English-language databases for peer-reviewed research articles. We reviewed research articles published over 20 years (2002–2022). We found 12540 articles, of which 39 deemed relevant, were analysed. The review highlighted the high risk of transport workers’ exposure to respiratory diseases during pandemics, exacerbated by structural inequalities including the significant number holding precarious/non-standard jobs. Increased financial strains led to poorer mental health outcomes and risks of detrimental behaviours for health. Economic measures implemented by governments were found to be insufficient in addressing these issues. The review found that transport is a significant transmission point for pandemics of respiratory diseases, and it suggests some remedies to best meet these challenges.