The present study investigates the occurrence of silicosis in Italy and its temporal trends and spatial patterns using mortality data. The aim is to give a contribution, albeit with a conservative estimate inferred from mortality data, to epidemiological knowledge of silicosis in Italy. Trends in mortality due to silicosis from 1990 to 2012 were evaluated and a municipal cluster analysis was performed. It shows that mortality due to silicosis is declining but still not eradicated and that one of its main features is regional variability: in this respect, the cluster analysis performed allowed to identify 34 different geographic areas. The results obtained may help display a more detailed picture of silicosis epidemiology and contribute to the fight against exposure to silica, an undisputable public health commitment