Background <p>Pneumoconiosis is still the most common occupational disease worldwide. The aim of the study was to evaluate the risk factors affecting survival in patients with pneumoconiosis who were followed up in occupational medicine clinics.</p> Methods <p>This retrospective descriptive study included all pneumoconiosis patients followed up in occupational medicine clinics between 2013 and 2023. The patients’ death records were accessed through the national death notification system.</p> Results <p>A total of 539 patients were included in the study. During the clinical follow-up, 14 (2.56%) patients had died. The mean overall survival time was 224 ± 13 months. In multiple analyses, silica exposure (<i>p</i> = 0.029) and lung cancer development (<i>p</i> = 0.002) were associated with survival. There was no difference between stages 0 and 1, stage 2 and stage 3 in terms of age at diagnosis, type of disease and duration of dust exposure (respectively <i>p</i> = 0.109, <i>p</i> = 0.852).</p> Conclusions <p>This study showed that exposure to silica as a dust type and the development of lung cancer increased mortality in patients with pneumoconiosis. Determining the factors that may be associated with mortality in patients with pneumoconiosis is important in patient follow-up and in developing preventive measures and policies. It is crucial that the establishment of lung cancer screening programs contribute to life expectancy.</p>