There is a causal correlation between the inhaled dose of asbestos at the working place, the occurrence of asbestosis, and a 5-fold increased mortality rate of lung cancer. Mesothelioma, which appears to be very rare among the general population, is a specific sign of exposure to asbestos fibres. Malignant tumours of the urinary bladder, the gastro-intestinal tract, the larynx and the oesophagus in workers may also be ascribed to the specific exposure in some cases. After a brief outline of the epidemiology of these diseases the carcinogenic effects of asbestos on the cellular and subcellular level are described. It can be shown from most recent literature that asbestos fibres can also trigger epigenetic and genotoxic effects. Numeric mutation of chromosomes, damage of the plasma membrane, and a modification of the immune system are most significant. In the presence of PAH, asbestos acts as a cocarcinogen. Asbestos fibres are positive in the cellular transformation test. Due to its initiating and promoting effects, asbestos proves to be a complete carcinogen. Obviously, asbestos fulfils the criteria of the modern theory of carcinogenesis as a multicausal and multistep process.