Carbon black is the general term for a powdery commercial form of carbon. It can cause adverse health effects after inhalation, ingestion, or dermal contact. Exposure to carbon black particles can have adverse effects on the respiratory system; this exposure usually occurs when people inhale contaminated air in the workplace. Here we report a patient with massive carbon black exposure at work who continues to have productive cough with black material in sputum for over a year after this one-time exposure. This patient worked as a repair man and welder at a carbon black manufacturing facility. He had an intense exposure to carbon black for 4-10 min when equipment in the plant malfunctioned. He developed immediate respiratory symptoms, and these have persisted for at least 1.5 years post exposure with a chronic productive cough with black particles. Cytological analysis of his sputum revealed carbon laden macrophages. A high-resolution computed tomography scan documented patchy alveolar infiltrates at the lung bases with septal thickening. His symptoms have partially improved with empiric treatment with a long-acting beta agonist and inhaled corticosteroids. This case demonstrates that a single one-time exposure to a dense fog of carbon black can result in particle deposition in the lung that persists for prolonged periods of time.