The Sago Mine had been cited 208 times by the federal Mine Safety and Health Administration in 2005 alone, up from 68 the previous year. Ninety-six of those violations were classified as significant and substantial. The mine was operated by Anker West Virginia Mining, a subsidiary chain running through Wolf Run Mining Company, Hunter Ridge Mining, and ultimately International Coal Group, formed in 2004 by investor Wilbur Ross from the bankruptcy remnants of Horizon Natural Resources. On the morning of January 2, 2006, an explosion ripped through the mine shortly after the first shift entered. Fourteen men on the second transport cart escaped. The twelve on the first cart, which had already passed the point of the blast, did not. A foreman on the second cart, whose own brother was among the trapped, re-entered the mine with four others to attempt a rescue, pushing a quarter mile in before air quality detectors forced them back.

Each miner carried a self-contained self-rescuer providing one hour of breathable air. Emergency supplies were stored in 55-gallon drums within the mine. But rescue was agonizingly slow. The mining company did not call a specialized mine rescue crew until 8:04 a.m., more than 90 minutes after the blast, and did not notify federal authorities until 8:30. MSHA personnel arrived on site at 10:30 a.m. Rescue teams had to advance cautiously, testing for explosive gas concentrations, water seeps, and unstable roof conditions, limiting their progress to a crawl. They disconnected their telephones between checkpoints to avoid sparks. MSHA deployed a 1,300-pound robot into the mine. For 41 hours, the families waited at the Sago Baptist Church, sustained by prayer and by the memory of the 2002 Quecreek Mine rescue, where nine trapped Pennsylvania miners had all been brought out alive.

Randal L. McCloy Jr., 26 years old, was the sole survivor among the thirteen trapped miners. Rescuers pulled him from the mine at approximately 1:30 a.m. on January 4, suffering from carbon monoxide poisoning, a collapsed lung, brain hemorrhaging, edema, and failing liver and heart function. He was stabilized at St. Joseph's Hospital in Buckhannon, then transferred to West Virginia University's Ruby Memorial Hospital in Morgantown. Two days later he was moved to Allegheny General Hospital in Pittsburgh for hyperbaric oxygen treatments to counteract the carbon monoxide. He remained in a coma for weeks, showing his first signs of awakening on January 18. Private funerals for the twelve deceased miners were held January 8 through 10, followed by a public memorial at West Virginia Wesleyan College on January 15. More than 2,000 people attended the service, which was televised live on CNN. Governor Joe Manchin and author Homer Hickam, a West Virginia native, spoke. Senators Robert Byrd and Jay Rockefeller attended in silence.

The cruelest chapter of the Sago disaster was the miscommunication. When rescue teams finally reached the miners, a message relayed from underground to the surface was misunderstood. Word spread that twelve miners were alive. For three hours, families celebrated at the church. Media outlets around the world reported the miracle. Then officials arrived to deliver the truth: twelve were dead, one was barely alive. The correction unleashed grief compounded by fury. Families who had been embracing in joy were now screaming in anguish, feeling manipulated by a system that had already failed to protect their loved ones underground. A West Virginia University journalism forum later called the episode one of the biggest media failures of the century. USA Today reporter Mark Memmott noted that the real story was not the media's error, but the deeper question: why mines were not safe, and why it took so long for rescuers to reach the trapped men.

The Sago disaster exposed systemic weaknesses in American mine safety oversight. Critics pointed to the MSHA's leadership under a former mining industry executive, to the 208 citations that had not prevented the explosion, and to an information policy that restricted public access to mine inspection records. The United Mine Workers of America fought for and won the right to participate in the investigation, over the objections of the mine's owner. The disaster prompted new federal mine safety legislation, including requirements for improved communication systems, additional oxygen supplies, and better rescue protocols. The Sago Mine itself reopened partially in 2007, but shut down permanently in 2009, citing high costs and low coal prices. The small community of Sago, nestled in the Appalachian hills of Upshur County, carries the weight of what happened beneath its surface, a reminder that the coal that powered a nation always came at a human price.