<p>Pneumoconiosis is a common occupational lung disease, and social media platforms such as TikTok and Bilibili have become important sources of health information. However, the quality and reliability of video content on these platforms remain unclear. In this cross-sectional study, 163 pneumoconiosis-related videos from TikTok and Bilibili in China were included. Information on video characteristics, uploader types, content themes, and presentation formats was extracted. We assessed video quality and reliability using GQS, mDISCERN, JAMA benchmark criteria, and VIQI. Correlation analysis was further performed to examine associations between video metrics and quality scores. TikTok videos had shorter durations and lower GQS (<i>P</i> = 0.002) and mDISCERN (<i>P</i> = 0.041) scores than Bilibili videos. In the combined analysis, mDISCERN and JAMA scores varied significantly across uploader groups. On TikTok, GQS, mDISCERN, and JAMA scores differed by uploader type, whereas on Bilibili, differences were observed for mDISCERN and JAMA scores. Correlation analysis further indicated that longer videos were negatively correlated with mDISCERN and JAMA scores on TikTok, but positively correlated with GQS scores on Bilibili. Pneumoconiosis-related videos on TikTok and Bilibili showed limited quality and reliability. Greater involvement from medical practitioners and stronger platform-specific regulatory strategies are needed to improve the educational value of health information on both platforms.</p>