Introduction: Information on the changes of pulmonary function and the right cardiac structure in patients with coal worker’s pneumoconiosis in China is very scarce. This study was performed to clarify the changes of pulmonary function and right cardiac structure in patients with coal worker’s pneumoconiosis in China. Material and methods: Pulmonary function, pulmonary artery systolic pressure, and the right cardiac structure were evaluated by spirometry and color Doppler echocardiography. Results: The pulmonary artery systolic pressure of patients with coal worker’s pneumoconiosis was increased with disease severity. Patients with coal worker’s pneumoconiosis also exhibited an impaired pulmonary function and altered right cardiac structure compared with control subjects. A significant linear correlation of the variables of pulmonary ventilation and diffusion function with the indicators of the right cardiac structure was found in patients with coal worker’s pneumoconiosis in China. Conclusions: This study elucidated a deterioration of pulmonary function and right cardiac structure in patients with coal worker’s pneumoconiosis in China.