Abstract: Objective To investigate the incidence characteristics of occupational pneumoconiosis and the status of government medical assistance in Ankang, providing a theoretical basis for local prevention and control strategies. Methods Data on newly diagnosed cases of occupational pneumoconiosis in Ankang from 2012 to 2022 were collected. Confirmed cases were used as the study population to analyze the incidence of occupational pneumoconiosis. Results A total of 1 208 cases of occupational pneumoconiosis were reported in Ankang during 2012—2022, accounting for 99.26% of all reported occupational diseases. The overall number of reported cases showed a fluctuating downward trend over time. Among these, 1 196 were newly diagnosed cases (99.00%). Stage I pneumoconiosis accounted for 574 cases (48.00%), Stage Ⅱ for 378 cases (31.60%), and Stage Ⅲ for 244 cases (20.40%). The predominant types were silicosis (728 cases), coal workers’ pneumoconiosis (467 cases), and cement pneumoconiosis (1 case). The main affected industries were mining, manufacturing, and construction, with 306 cases (25.59%). All 1 196 newly diagnosed cases were male. The most common age at diagnosis was 40 to 49 years (46.91%), while the most frequent age of initial dust exposure was 20 to 29 years (41.47%). Workers with 5 to 14 years of dust exposure accounted for 47.91%. A total of 85.62% of cases were concentrated in Ziyang, Pingli, and Xunyang counties. The proportion of Stage Ⅲ silicosis cases was significantly higher than that of coal workers’ pneumoconiosis (P < 0.05). Among the 1 196 newly diagnosed patients, 890 (74.41%) received government medical assistance. Conclusions Occupational pneumoconiosis remained a major focus of occupational disease prevention in Ankang, with silicosis and coal workers’ pneumoconiosis being the most prevalent types. A high proportion of patients benefited from government medical assistance. Strengthening regulatory oversight in mining, manufacturing, and construction industries is essential for effective occupational disease control in the region.