A fuller's earth worker developed signs of pneumoconiosis. Pathological examination of the lung tissues showed interstitial collections of dust laden macrophages associated with mild fibrosis. Mineralogical analysis showed a high content of montmorillonite. This study shows that a pneumoconiosis can result from prolonged heavy exposure to calcium montmorillonite (fuller's earth) in the absence of quartz. The disease is relatively mild and associated with little clinical disability.