Pneumoconiosis, an interstitial lung disease that occurs from breathing in certain kinds of damaging dust particles, is a major occupational disease in China. Patients diagnosed with occupational pneumoconiosis can avail of free medical treatment, whereas patients without a diagnosis of occupational diseases cannot not claim free medical treatment in most provinces from the government before 2019. This study aimed to analyze the priority of medical facility selection and its influencing factors among patients with pneumoconiosis. A total of 1,037 patients with pneumoconiosis from nine provinces in China were investigated. The health service institutions most frequently selected by the patients were county-level hospitals (37.5％). The main reason for the choice was these hospitals' close distance to the patients' homes (47.3％). The factors for the choice of health care institutions were living in the eastern region (OR = 2.91), living in rural areas (OR = 2.10), silicosis diagnosis (OR = 2.44), employment in private enterprises (OR = 2.91), smoking (OR = 2.69), and quit smoking (OR = 3.98). The diagnosis, treatment, and rehabilitation therapy of pneumoconiosis should be enhanced in primary medical institutions.