Silicosis and tuberculosis (TB) are significant mining-related illnesses in developing countries. The purpose of this study was to examine annual cases of these diseases in Zambian miners, including comparison of periods before (1960-1970) and after (1992-2002) the arrival of the HIV/AIDS pandemic. The Occupational Health and Safety Research Bureau of Zambia reported 2114 cases from 1945 to 2002. Of these, 22.7% were silicosis, 65.4% TB, and the remaining 11.9% silicotuberculosis. While silicosis cases decreased from 28.6% to 12.4% with the arrival of HIV/AIDS, there was a large increase in tuberculosis cases (37.1% to 86.1%), with a corresponding decrease in silicotuberculosis cases (34.3% to 1.6%). Although silicosis remains an occupational health issue in Zambian miners, the most significant problem appears to be the marked increase in cases of TB.