Pneumoconiosis is a systemic disease caused by long-term inhalation of productive dust, mainly diffuse fibrosis of lung tissue, and is the most common type of occupational disease. China has classified twelve types of pneumoconiosis such as: silica, coal, graphite, carbon black, asbestos, talc, cement, mica, potter, aluminum, welder, and caster pneumoconiosis as occupational diseases. Silicosis is caused by long-term inhalation of free SiO2. When the content of free Si02 in dust is between 40% and 80%, fast-acting silicosis can occur, with rapid progression of lesions and often severe impairment of lung function. Coal workers’ pneumoconiosis is the most common type, and the nature of the lesion is determined by the type of dust exposure, and coal lung and coal silicosis are collectively referred to as coal workers’ pneumoconiosis in China. Asbestosis is caused by long-term inhalation of asbestos dust and progresses more slowly than silicosis. The incidence of lung cancer is 2-10 times higher than that of the general population. The development of pneumoconiosis is a complex pathological process influenced by multiple factors, of which alveolar macrophages play a key role. The pathogenesis of pneumoconiosis is still unclear. 30%-50% of the dust can be retained in the nasal cavity, and the dust that enters the peripheral airways and lungs can be removed through the bronchi, alveoli, interstitial and lymphatic vessels. However, when the amount of inhaled dust exceeds the body’s self-purification capacity or when the clearance mechanism becomes impaired, the dust accumulates in the lungs and causes a series of reactions in the lung tissue. The most common pathological changes are: alveolitis, focal and nodular changes and massive fibrosis, which may be accompanied by changes in the structure of the intrathoracic lymph nodes or their disappearance. Dyspnea, cough, sputum and chest pain are the main clinical manifestations in pneumoconiosis patients. Chest pain is more common in patients with silicosis and asbestosis. The cause may be related to fibrosis of the pleura, thickening of the pleura, and pulling of the alveoli under the dirty pleura. Hemoptysis is rare in pneumoconiosis patients. When chronic inflammation of the upper respiratory tract causes damage to the mucosal vessels, it can cause a small amount of blood in the sputum. When pneumoconiosis is combined with pulmonary tuberculosis, hemoptysis can occur, and care should be taken to exclude the possibility of combined lung tumors. In the early stages of pneumoconiosis, there are usually no signs, but large fibrosis mostly occurs in the upper posterior part of both lungs, and localized fibrillation may be enhanced, with turbid or even solid sounds on percussion and diminished breath sounds on auscultation. In cases of combined heart failure with pulmonary heart disease, various signs of heart failure are seen. A typical X-ray shows small round shadows in the lung field, which gradually increase in size and density as the lesion develops, and the distribution gradually expands to the whole lung, with some fusion into large fibers. When coal workers’ pneumoconiosis is complicated by tuberculosis, pneumoconiosis nodules are formed, and the small round shadows increase more rapidly to form large shadows with blurred margins and smooth outer edges, forming emphysema around the periphery, with the lesions mostly located in the upper lung fields, with scar-like atrophy of the upper lobes after fiber contraction and upward migration of the hilum. To date, pneumoconiosis is still preventable and incurable, with emphasis on the treatment of comorbidities. Patients are promptly removed from dust operations, treated comprehensively according to their condition, and measures such as active prevention and treatment of tuberculosis are aimed at reducing symptoms, delaying progression, improving quality of life, and extending life expectancy. Hanfang has methylene can loosen and degrade lung collagen fibers, and is an anti-silicosis and anti-tumor potentiating drug developed in China. Anti-silicosis: 60-100mg, three times a day. The main action links of Kexipin include preventing the deposition of dust in the lung and increasing the contouring function of the lung, etc., but it is less commonly used clinically. Recurrent lung infections, tuberculosis and respiratory failure are the three major comorbidities of pneumoconiosis and common causes of death. Active treatment of comorbidities is currently the main treatment measure. Recent advances in immunosuppressant research have created conditions for organ transplantation, but the difficulty and high cost of transplantation techniques and the difficulty of donor sources have limited its clinical application. Bilateral large volume lung lavage can remove a certain amount of dust deposited in the airways and alveoli, as well as fibrosis-related factors generated by dust irritation, which is considered to have etiologic significance, while lavage can cause the discharge of secretions retained in the airways, which is better for improving the patient’s subjective symptoms. Pulmonary rehabilitation and psychotherapy are now receiving increasing attention.