A 43-year-old stone cutter with 13 years of exposure to silica developed a pulmonary silicosis and a glomerulonephritis with moderate renal failure. Renal biopsy demonstrated in light microscopy a segmental and focal mesangial proliferation and in electron microscopy distinct alterations of the proximal tubular cells. Renal histology suggest silica may play a part in the pathogenesis of renal damage. Clinicians should therefore include silica exposure in the differential diagnosis of unexplained glomerulonephritis.