Asbestosis, caused by inhalation of asbestos fibers, remains a serious occupational and environmental health hazard with a protracted latent period before clinical manifestation. The World Health Organization (WHO) classifies all forms of asbestos, including those that cause pneumoconiosis-like lung cancers, as carcinogenic and has called for their ban globally. Despite this, India continues to import and use chrysotile asbestos, the most common variety, citing lack of conclusive evidence, occupational safety measures, and wet processes as mitigating factors—an idealized scenario rarely met outside controlled conditions. Notably, the Mines Act (1952) listed asbestos-related diseases as notifiable due to cancer risk, and by 2005, Indian physician-led studies confirmed the carcinogenicity of all asbestos types with no safe exposure threshold. Contrarily, prominent institutions like the Indian Council of Medical Research (ICMR) have questioned such conclusions based on limited long-term epidemiological data. This restricted evidence scope ignores extended latency, demolition exposures, environmental dispersal of asbestos fibers, and incomplete protection from face masks in occupational settings. The Central Pollution Control Board's studies revealing various lung cancers linked to asbestos underscore the urgency for stricter regulation. Kerala’s proactive 2009 ban on asbestos roofing exemplifies regional steps, but lack of a nationwide prohibition undermines public health priorities amid substantial economic interests benefiting from cheap asbestos cement in construction and industrial applications. The Indian government's stance prioritizing "wet process" controls effectively overlooks real-world exposure conditions, perpetuating asbestos-related morbidity. Given the substantial latency and fatality associated with asbestos-induced diseases, comprehensive public health policy reform including an outright ban, rigorous worker protections, and environmental decontamination is imperative to mitigate this preventable hazard in India's vast at-risk populations. Continued denial and regulatory inertia exacerbate morbidity and mortality burdens from asbestosis and related lung cancers, making asbestos a silent killer demanding urgent attention in India's occupational and environmental health agenda.