Since the beginning of the 1960s, toluene has been used as a solvent in all German rotogravure printing plants in a high degree of purity. These particular exposure conditions allow the investigation of the potential carcinogenicity of long-term toluene exposure. A historical cohort study was performed that included 6830 German men from 11 plants who were exposed to toluene from 1960 to 1992 in three work areas with different exposure levels. Overall, 466 deaths were observed, which provided a standardized mortality ratio (SMR) of 91.3 for overall mortality. A significantly decreased SMR for total mortality was seen in one of the three work areas (SMR = 67). Mortality from cancer did not differ substantially from the expected level, but in one of the work areas, mortality from cancers of the bone (Ninth Revision of the International Classification of Disease [ICD]-9 170; SMR = 813) and connective tissue (ICD-9 171; SMR = 631) was significantly elevated. In the entire cohort, mortality from lung cancer was increased by about 35% above total mortality, and by about 95% in one work area with low toluene exposure (not statistically confirmed). The SMR for death from alcohol dependence was statistically significantly increased (ICD-9 303; SMR = 314).