Crystalline silica inhalation causes silicosis, one of the ancient occupational lung diseases. It leads to an irreversible fibrotic response in the lung parenchyma and, consequently, causes diffuse interstitial lung disease. Asymptomatic to chronic irreversible forms are various presentations of silicosis, which has a high-risk predisposition to various comorbidities. We documented two cases of rare presentations of silica dust exposure alveolar silicoproteinosis and silicotuberculosis.