Abstract: Refractory ceramic fibers (RCF), a substitute for asbestos, are often used as high-temperature insulation applications, but can be inhaled during production and using. However, epidemiological studies in Europe and the United States have not shown that occupational RCF exposure has association with the occurance of lung diseases. The tolerance of RCF is less than amphibole asbestos, but more than other man-made mineral fibers (MMMF). Toxicology studies with various exposure methods have shown that RCF can cause pulmonary fibrosis, lung cancer, and mesothelioma. This article provided a comprehensive and integrated review of the epidemiology toxicology of RCF, and illustrated perspectives for the further research.