We have investigated newly reported pneumoconiosis cases in the province of Hubei, China from 2008 to 2013, to identify the major problems and challenges, and explore possible solutions for its prevention and control. We analyzed the data on new cases of pneumoconiosis from annual reports, including case distributions, patient ages, exposure duration, disease stages, and enterprise types. A total of 3665 new pneumoconiosis cases were reported between 2008 and 2013 in Hubei Province. Coal workers’ pneumoconiosis and silicosis, which accounted for 97.19% of the total, were the most common types. The duration of exposure of 33.32% cases was less than 10 years. Most of the new pneumoconiosis cases worked in industries that produced coal, nonferrous metal, or building materials. About 42.46% of pneumoconiosis cases were from small and medium-sized enterprises. The proportion of cases with combined pneumoconiosis and tuberculosis was 6.6%, and the incidence of tuberculosis was highest in workers with silicosis. The current situation of pneumoconiosis in China is serious. Lack of attention to occupational health, inefficient surveillance, and weak occupational health services may have contributed to the increased new pneumoconiosis cases. Full article