Pulmonary siderosis is a rare occupational lung disease. Traditionally, it has been considered a "benign pneumoconiosis" because of the absence of associated clinical symptoms or pulmonary fibrosis. However, few authors have reported the evidence of pulmonary symptoms with lung fibrosis on high-resolution computed tomography and lung biopsy. Symptomatic pulmonary siderosis in scissors/knife sharpening worker has not been described in past literature. We report a case of biopsy proven symptomatic pulmonary siderosis in scissors/knife sharpening worker, who was unnecessarily treated with antitubercular therapy for 3 months.