Pneumoconiosis is the most serious occupational disease in the world. Among all the pneumoconiosis, silicosis accounts for the majority of cases. At present, there are no specific treatments, and available therapies for silicosis can only alleviate symptoms and delay pulmonary fibrosis, producing effects less than satisfactory. Stem cell therapy as a safe and effective new method featuring no immune rejection and wide application has been studied in many diseases, including silicosis. This paper reviewed the research of mesenchymal stem cells in silicosis model in recent years. The potential mechanisms of lung injury induced by silica and the proposed protective mechanism of mesenchymal stem cells in silicosis model were described, including inhibiting inflammatory factors, apoptosis, or endothelial mesenchymal transition, reducing the level of pro-fibrosis cytokines, and regulating autophagy. Problems and future development directions of mesenchymal stem cells in the treatment of silicosis were also discussed.