Silicosis is one of the oldest occupational diseases known to man. It is an irreversible fibrotic lung disease caused by inhalation of crystalline silicon dioxide or silica. In spite of optimal regulation in the developed countries, exposure to respirable crystalline silica dust is still a major occupational health problem however the scenario is far more adverse in the industrially developing countries. The USA, Europe, China and India are listed in the top among the countries where the prevalence of silicosis is still extremely high and approximately more than 5 million people are exposed to respirable silica dust globally however the number is still too low because of almost parallel numbers of undiagnosed cases. Silica induces a series of inflammatory reactions that further trigger a chronic or acute fibrotic change in the lungs. Silicosis is often followed by other comorbidities among which tuberculosis, chronic obstructive pulmonary disease (COPD) and cancer are most prevalent. As of now, there is no curative treatment however inclusive management strategies may help to recover quality of life and slow deterioration. Regular medical examinations should be available to all workers who may be exposed to crystalline silica. Further efforts are needed for recognition and control of silica hazards, especially in developing countries.