Objective : We examined the putative association between the psychological symptoms and hypoxemia in hospitalized pneumoconiosis patients. Methods : One hundred and nine hospitalized pneumoconiosis patients were divided into two groups according to their level of hypoxemia (PaO2); hypoxemic group consisted of 47 patients with PaO2 lower than 80 mmHg, and comparative group consisted of 62 patients with higher than 80 mmHg. All of them were interviewed with the Hamilton Depression Rating Scale (HAM-D), and completed the Symptom Checklist-90items-Revised (SCL-90-R) and the State-Trait Anxiety Inventory (STAI). The medical data (PaO2, PaCO2, Hb, and Hct), number of hospital days and socio-demographic data as well as scores of the three psychological measurements were compared between the two groups. Results : Hypoxemic patients with lower PaO2 showed higher scores in the HAM-D (p=0.01) and stateanxiety subscale of the STAI (p<0.05). Values of hemoglobin and hematocrit were negatively correlated with levels of trait-anxiety (p<0.05). Thirty patients (27.5%) of total subjects suffered from depression (higher than 18 in the HAM-D), and 46.8% of hypoxemic patients were depressed, whereas 12.9% of comparative group patients were depressed (p=0.01). Conclusion : These results suggest that depression and anxiety might be associated with the hypoxemic mechanism in pneumoconiosis patients.