Pneumoconiosis (PNC) is an occupational lung disease characterized by irreversible fibrous lesions in the lung resulting from chronic inhalation of silica or inorganic dust, often in mines. We evaluated the differences of clinical characteristics and prognosis between the lung cancer patients with pneumoconiosis (WP) and without pneumoconiosis (WOP). Methods We reviewed the medical records and imaging studies of 227 patients who had been diagnosed lung cancer from 1 January 2009 to 31 December 2010 in suburban tertiary teaching university hospital, and we investigated the differences of clinical character-istics between lung cancer patients with WP and WOP. Statistical analyses were performed using the chi-square or Fisher`s exact test, or T-test or the Mann-Whitney U test. Results WP patients were 20/227(7.3%), all of 20 were men. Seven were simple PNC, 13 were complicated PNC. The mean age of WP and WOP were 69.1±19.9 and 69.8±22.2(P=0.362), percentages of men in WP and WOP were 20(100%) and 163(78.7%). When looking at the cell types of WP and WOP, non-small cell carcinoma(NSCLC) were 18/20(90%) and 167/207(80.6%)(P=0.349). In subgroups of cell type in NSCLC of WP and WOP, SCC 12/18(60.0%) and 82/167(49.1%), adenocarcinoma 6/18(33.3%) and 75/167(44.9%) was (P=0.266). The patients accompanying chronic obstructive pulmonary disease in WP and WOP were 17/20(69%) and 76/227(31%)(P=0.007). The incidences of history of pulmonary tuberculosis (PTB) in WP and WOP were 75% and 21.4% (P＜0,000). In our study, WP patients had more COPD and pulmonary tuberculosis history, and tendency.