Objectives: The aim of this study was to study the patients working in stone crushing units presenting with respiratory symptoms for occupational lung disease, silicosis. Patients and Methods: Over a span of 2 years, 176 consecutive new stone crusher workers diagnosed with silicosis were clinically evaluated, including radiological investigations, spirometry, and sputum for acid-fast bacilli. Results: All patients were male manual workers with average age and duration of stone dust exposure of 42.9 years and 20.11 years, respectively; 57 (32.3%) gave a history of smoking; 33% of patients had taken anti-tubercular treatment in the past. However, sputum of none of the patients was found positive for acid-fast bacilli. Only 4 (2.2%) patients mentioned the use of gloves and masks during work shifts. Breathlessness was the most common symptom (92%), followed by cough (61.9%), chest pain (48.3%), expectoration (6.8%), hemoptysis (5.7%), and wheezing (2.8%). Chest radiograms showed opacities-small (up to 10 mm, 57.95%) and large (>10 mm, 17.04%); pleural thickening (97.2%), diaphragmatic thickening (97.2%), and calcifications (71%) etc., Predominant lesions on high-resolution computerized tomography scan of the thorax were mediastinal lymphadenopathy (94.3%), round opacities (90.3%) followed by parenchymal bands (59.1%) and linear opacities (52.8%). On spirometry, 71 (40.3%) patients had findings within the normal limits. Conclusion: It is reiterated that silicosis has severe debilitating effects on the health of subjects, and the situation warrants continuous monitoring.