Silicosis is a fibrotic occupational pulmonary disease that results from over-exposure to crystalline silica-containing dust. Silicosis is a progressive disease which can often lead to advanced respiratory failure, the need for lung transplantation or death. There are a number of silicosis associated diseases which constitute diagnostic challenges, as well as contribute to further morbidity. Although preventable through appropriate workplace precautions, silicosis not only remains an endemic disease worldwide, it has also manifested a resurgence of epidemic disease in recent years, as seen in the inclining prevalence of disease in Israel. This review aims to present the silicosis epidemic in Israel, its causes and the ways to prevent further outbreaks of disease. We describe clinical and radiological imaging features, associated diseases and differential diagnosis for the purpose of raising awareness of the disease among medical professionals thus promoting early detection and diagnosis.