A recent scoping review examined the Indian evidence on silicosis, focusing on prevalence, risk factors, regional variation, diagnostic approaches and policy gaps. The review identified substantial disease burden across high-risk occupations, with particularly high reported prevalence in some mining and stone-processing populations. It also highlighted wide variation between studies, reflecting differences in exposure, workforce characteristics and diagnostic methods. The paper is highly relevant to the NAPCON occupational lung disease track because it connects occupational exposure to real-world clinical and public-health challenges in India. For HCPs, the central lesson is that exposure history remains fundamental: the absence of smoking should never be taken as evidence against occupational lung disease. Diagnosis requires appropriate imaging and lung-function assessment, while prevention depends on exposure control, workplace protection, surveillance and early recognition. The review also emphasizes gaps in awareness and regulatory implementation. Because prevalence estimates vary considerably across settings, individual figures should not be extrapolated to all Indian workers. Nevertheless, the overall evidence supports a proactive approach to workers exposed to respirable crystalline silica and strengthens the case for integrating occupational history into routine respiratory assessment.