In Pakistan the Siwalik region is exposed to ionizing radiation (IR) from uranium mineralization. The current research describes the impact of long-term low-dose terrestrial ionizing radiation exposure on the hematopoietic indices of the region’s inhabitants. Mean values of the selected complete blood count (CBC) parameters were calculated to examine low or high trend. A t-test was conducted on the mean values of CBC parameters to analyze parameters showing a significant difference between radiation-exposed people and radiation unexposed people. Most disturbed CBC parameters found low were: mean corpuscular hemoglobin (MCH) 52%, mean corpuscular hemoglobin concentration (MCHC) 44%, and platelets (PLT) 28%. The most affected CBC parameter which was found to be high was lymphocyte count (LYM) 28%. Seven CBC parameters, including hemoglobin (HB), white blood cells (WBC), platelets (PLT), hematocrit (HCT), neutrophils (NEUT), MCH, and MCHC, showed a decrease trend in radiation-exposed residents and two CBC parameters, including red blood cells (RBC) and LYM, showed an increased trend. Significant differences were found in the parameters viz., HB, WBC, MCH, MCHC, HCT, and LYM by the t-test between radiation exposed and unexposed individuals. The odds of developing a low MCH were four times higher and the odds of developing a low MCHC were 4.4 times higher for radiation-exposed individuals as compared to radiation unexposed. The persistent low-dose IR exposure resulted in anemia and immune modulation in radiation-exposed residents.