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Introduction The extensive use of asbestos in naval vessels, aircraft, and other UK military infrastructure during the 20th century has resulted in elevated risks of pleural and parenchymal asbestos-related diseases among military personnel. This study aimed to examine the causes and trends of such diseases as reported through a national voluntary reporting scheme.Methods Surveillance of Work-Related and Occupational Respiratory Disease (SWORD) scheme, part of the THOR (The Health and Occupation Reporting) network, collects notifications from UK respiratory physicians on occupational lung diseases to support epidemiological surveillance. We analysed cases where (1) reported agent was asbestos, (2) occupation was linked to the military, and (3) diagnosis included benign pleural disease, mesothelioma, bronchial cancer, or asbestosis.Results There were n=356 cases (1996–2003; estimated actual cases=1,570), n=404 disease episodes (plaques=48% diffuse pleural thickening=13%, mesothelioma=29%, asbestosis=18%, bronchial cancer=5%). Cases peaked 1999–2003 (n=91), declining steadily to n=11 (2020–23). Most cases (89%) were linked to Royal Naval (RN) service. Among 52 RN asbestosis cases, marine engineers, stokers, artificers, and electricians were most frequently affected, though 15% of cases occurred in non-engine room roles (e.g., aircraft maintenance, food preparation, stevedoring, and radio-telecommunications).Conclusion Asbestos respiratory disease remains a concern, though cases have declined significantly, reflecting improvements in exposure control and safety measures. Ongoing surveillance is essential, particularly for veterans in non-engineering roles who have expereinced significant risk.