ObjectiveTo investigate the correlation of polymorphism and loci interaction of nucleic acid binding oligomeric domain-like receptor heat protein domain associated protein 3 (NLRP3) gene and susceptibility to coal workers' pneumoconiosis (CWP) in Xinjiang Region. Methods A total of 109 CWP were selected as the case group, and 69 coal miners with similar age, years of dust exposure and work types were selected as the control group by convenient sampling method. Blood samples of individuals in workers in these two groups were collected, and the genotypes of single nucleotide polymorphism loci, rs1539019, rs4612666, rs4925650 and rs7525979, in the NLRP3 gene were detected using an improved multiplex ligation detection reaction. The optimal genetic model was selected based on the Akaike information criterion. Results The results of unconditional logistic regression analysis showed that individuals with the C allele of rs1539019 or rs4612666 had a higher risk of CWP than those with the A or T allele (all P<0.05), and individuals with the AA genotype of rs1539019 or the TT genotype of rs4612666 had a lower risk of CWP than those with the CC genotype (all P<0.05), after adjusting for age, years of work, alcohol, and smoking. The optimal genetic models for rs1539019 and rs4612666 were the recessive model and the additive model, respectively, and these differences were associated with the susceptibility to CWP at the Bonferroni-corrected level (all P<0.05). No correlation was found between rs4925650 and rs7525979 and the susceptibility to CWP (all P>0.05). In the smoking population, the rs1539019 co-dominant model, recessive model, and additive model were associated with a decreased risk of CWP (all P<0.05). The rs4612666 co-dominant model, dominant model and additive model were associated with an increased risk of CWP (all P<0.05), with the optimal genetic models being the recessive model and the additive model among smokers. The rs1539019 and rs4612666 were not found to be associated with the increased risk of CWP in non-smokers (all P>0.05). The rs4612666 dominant model and additive model were associated with an increased risk of CWP (all P<0.05), and the rs4925650 recessive model and over-dominant model were associated with a decreased and increased risk of developing CWP (all P<0.05), with the optimal genetic models being the dominant model and the over-dominant model in drinkers. The rs1539019 co-dominant model, dominant model, recessive model, and additive model were associated with a decreased risk of developing CWP (all P<0.05), and the rs4612666 co-dominant model, recessive model, and additive model were associated with an increased risk of developing CWP (all P<0.05), with the optimal genetic models being the additive model and the recessive model in non-drinkers. The result of haplotype analysis showed that the ACAC and ACGC haplotypes were associated with a reduced risk of CWP (all P<0.05). Conclusion The rs1539019 and rs4612666 loci of the NLRP3 gene are associated with susceptibility to CWP. This study provides clues for further research on the risk of CWP in coal workers.