A jury in the US state of Missouri has ordered Johnson & Johnson (J&J) to pay $72m (£51m) to the family of a woman who claimed her death was linked to use of the company's Baby Powder talc.
Jackie Fox from Birmingham, Alabama died of ovarian cancer last year, aged 62, having used the talc for decades.
Her family argued that the firm knew of talc risks and failed to warn users.
J&J denied the claim and is said to be considering an appeal. Researchers say links with ovarian cancer are unproven.
A company spokeswoman said: "We have no higher responsibility than the health and safety of consumers, and we are disappointed with the outcome of the trial.
"We sympathise with the plaintiff's family but firmly believe the safety of cosmetic talc is supported by decades of scientific evidence."
Other cases pending
The verdict at the end of the three-week trial was the first time damages have been awarded by a US jury over talc claims.
More than 1,000 similar cases are pending nationwide and lawyers said thousands more could now be filed.
Is talc safe?
There have been concerns for years that using talcum powder, particularly on the genitals, may increase the risk of ovarian cancer.
But the evidence is not conclusive. The International Agency for Research on Cancer classifies talc used on the genitals as "possibly carcinogenic" because of the mixed evidence.