OBJECTIVE:To study prevalence and pattern of morbid conditions and to compare these amongst opencast and underground coal miners. METHODS: A cross sectional study was carried out at one of the coal mines having both opencast and underground mines in central India. By systemic stratified random sampling, 204 study subjects each from opencast and underground mines were selected. RESULTS: Prevalence of morbid conditions was found significantly (p < 0.05) more in underground miners (65.7%) as compared to opencast miners (54.4%). A significant linear trend was observed between length of service and prevalent morbid conditions in both the groups (p<0.001). Prevalence of morbidities was significantly (p<0.001) more in underground miners as compared to opencast miners, especially chronic respiratory morbid conditions (21.6% versus 7.8%) and musculoskeletal conditions (28.9% versus 12.2%). Mean values of forced vital capacity and forced expiratory volume of underground miners were significantly (p<0.001) lower than in opencast miners (FVC 2.80 0.55 liters versus 2.98 0.53 liters; FEV 2.9 0.21 liters versus 3.01 0.36 liters). Multivariate analysis revealed significant role of miner's age, place of work, past history of underground mining exposure, length of service and smoking habit in reduction of FVC and FEV. CONCLUSION: Underground miners carry more risk of developing morbidities. Chronic respiratory diseases, musculoskeletal problems, skin diseases and backache are more prevalent in underground miners than in opencast miners. Miner's age, place of work, past history of underground mining exposure, length of service and smoking habit significantly affect FVC and FEV.