The decision opens the way for up to 500,000 current and former miners to sue about 30 companies for damages after suffering silicosis from dangerous underground working conditions dating back decades.
Many miners caught silicosis, which has no known cure, from inhaling silica dust while drilling rock. The dust lodges in the lungs and causes permanent scars.
Symptoms include persistent coughing and shortness of breath, and the disease regularly leads to tuberculosis and death.
"It is the only avenue to realise the right of access to the courts provided by the constitution."
A group of about 60 former miners brought the case, which is set to expand to involve thousands of elderly men from the poorest rural areas of South Africa as well as Lesotho, Swaziland, Malawi and Mozambique.
They accuse 32 mining companies -- including Harmony Gold, Anglo American, Anglogold Ashanti and Gold Fields -- of knowingly and systematically failing to protect workers against silicosis.
Speaking on the steps of the High Court, former miner Vuyani Bwadube, who contracted silicosis after 16 years working for Harmony Gold, said there was "no turning back".
"Today's judgement is most welcome... The companies do not have time for us. Even today they don't care," he said.
"Today I am thankful to our leaders and our supporters in this case. We are moving forward now. We are going to win this case."
"It's a historic day for goldmine workers on whose back this country's wealth was built," said miners' lawyer Charles Abrahams.
The mining companies issued a statement saying they were studying the court's decision.
"It should be noted that the finding does not represent a view on the merits of the cases brought by claimants," it said.
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