Objective To explore the value of MRI in the differential diagnosis of pulmonary masses in patient with silicosis. Methods 12 cases with silicosis and pulmonary masses were preformed with 1.5T MRI, and the scanning sequences including axialT1WI ,T2WI and SPIR. The primary diagnosis of lesion nature was proposed by the MRI signal and morphology changes of masses. Results MRI results of 12 cases with silicosis and pulmonary masses showed that 9 cases complicated with lung cancer and 3 cases with silicotic fused mass.The coincidence rate was 100% according to the clinical follow up and pathological biopsy. The MRI characteristics of silicotic fused mass were strip-shaped shadow connected with the pleura between the chest wall and mediastinum. The masses showed homogeneous equal signal intensity on T1WI and inhomogeneous equal or low signal intensity on T2WI and SPIR compared to chest wall soft tissue. Masses of lung cancer showed lobulated sign and equal signal intensity on T1WI, high signal intensity on T2WI and SPIR. Of all 9 cases with complicated lung cancer patients, 2 cases complicated with pulmonary atelectasis,and 1 cases with obstructive pneumonia. Conclusion Magnetic resonance imaging is valuable for the differential diagnosis of pulmonary masses in patient with silicosis.