Historically, coal miners have known that roof shales can deteriorate in contact with humid mine air, causing massive roof falls and injuries from falling rock. It is critical to recognize rocks prone to weathering and to adequately support these rocks in order to ensure the long-term stability of the openings. In a recent study, NIOSH has used a wet/dry cycling test to determine the moisture sensitivity of over 800 specimens of roof rock from 25 U.S. coal mines. Fireclays and some gray shales are the most moisture-sensitive. Rocks with disturbed bedding, in contrast to flat-bedded rocks, are also more sensitive to water. Black shales are relatively un-reactive to moisture and serve to protect more reactive gray shales above. Mines that have roof rocks with moisture-sensitivity indexes above 40% can experience slaking roof conditions, and many require high coverage surface controls. Three case studies are presented in which the moisture-sensitivity index is correlated to roof conditions underground, and can be used to indicate long term deterioration. Engineering measures are described to control moisture-sensitive roof. In one case, roof screen not only reduces injuries from rock fall but also is shown to reduce roof falls.