Pneumoconiosis has many known causative substances; however, there are no reports of pneumoconiosis caused by gold powder inhalation. We report the case of a 21-year-old female patient with pneumoconiosis caused by gold powder. The patient had painted gold powder onto mortuary tablets 3 years ago. She visited our hospital with a cough and slight dyspnea, and her chest radiography and thoracic computed tomography scan revealed diffuse centrilobular particle-like shadows. Bronchoscopy with transbronchial lung biopsy revealed a black foreign body, which had been phagocyted by multinucleated giant cells. The foreign body was identified as gold particles by an electron probe microanalyzer, and the patient was diagnosed with pneumoconiosis caused by gold powder inhalation. She was reassigned to another job, after which her symptoms completely disappeared. This case showed a disease pattern similar to that of hard metal lung disease based on the findings, including the appearance of multinucleated giant cells, hypersensitivity pneumonitis-like clinical course, and a short exposure time to the dust.