Asbestos is a heterogeneous mineral fiber with considerable heat resistance and sound-abatement properties. It is relatively easily mined and processed and has been applied in a number of forms to ships and buildings. Unfortunately, respirable asbestos fibers have significant pathologic effects on the human lung and other organs. These effects can result in characteristic pleuropulmonary diseases, which become manifest after a latency period of 10 to 40 years from first exposure. This brief review will outline some major current controversies in the clinical approach to evaluation of asbestos-induced lung diseases.