Two patients are described who developed progressive massive fibrosis (PMF) after exposure to coal dust for only four and seven years, respectively, in Belgian coal mines in the post-war period. It seems likely from consideration of epidemiological data that these men were exposed to massive concentrations of coal dust during their time in the mines. In one patient a computerized tomography scan clearly showed the extent of the PMF and brought out the degree of calcification in the center of the masses. Radionuclide angiocardiographic evaluation showed depressed right ventricular function which is probably a result of pulmonary hypertension, and also showed marked distortion of the pulmonary vascular bed. It is believed that these are the first reported instances of CT scanning and radionuclide angiocardiography in this condition.