Aspergillus fumigatus is an apportunistic nosocomial pathogen in immunosuppressed patients or in the lesion where the local defense mechanism was impaired. Patients with pneumoconiosis are known to be susceptible to chronic necrotizing pulmonary aspergillosis. Therefore, we hypothesized that A. fumigatus might be prevalent in sputum from patients with coal workers’ pneumoconiosis, and also that asthmatic symptoms in patients with coal workers’ pneumoconiosis may be associated with the presence of A. fumigatus. We tested for A. fumigatus in the sputum from patients with coal workers’ pneumoconiosis by nested polymerase chain reaction amplification of the Aspf l gene. Sequences specific for this gene were detectable in 5 of 11 (45.5%) patients with coal workers’ pneumoconiosis with asthmatic symptoms (group A), 5 of 10 (50.0%) patients with coal workers’ pneumoconiosis without asthmatic symptoms (group B) and only 1 of 9 (11.1%) patients with chronic airflow obstruction without pneumoconiosis (group C). The frequency of the Aspf l gene detection was significantly higher in groups A and B than in group C (p < 0.05). The prevalence of A. fumigatus was not associated with asthmatic symptoms. These results demonstrated that A, fumigatus was prevalent in patients with coal workers’ pneumoconiosis. We speculate that colonization with A. fumigatus may be associated with this disease.