In spite of a decreasing number of new cases of silico-tuberculosis even today there still remains a serious complication of silicosis. The job of radiology is to recognise the disease, evaluate the course of the disease during therapy and classify the disease for compensation purposes. Due to the pathogenetic and pathomorpohologic similarities of silicosis and tuberculosis, it is often difficult and sometimes even impossible to recognise the presence of tuberculosis in cases of silicoses or to identify and isolate the TB component in silicotuberculosis. Careful consideration of all radiological and clinical parameters improves the accuracy of diagnosis. Since the radiographic examination provides the only method of evaluating the morphologic state of the disease, radiology will keep its central position in the diagnosis of silicotuberculosis.