Johnson & Johnson has been ordered to pay $4.7bn (£3.6bn) in damages to 22 women who alleged that its talc products caused them to develop ovarian cancer.
A jury in the US state of Missouri initially awarded $550m in compensation and added $4.1bn in punitive damages.
The verdict comes as the pharmaceutical giant battles some 9,000 legal cases involving its signature talcum powder.
J&J said it was “deeply disappointed” and plans to appeal.
In the six week trial, the women and their families said they developed ovarian cancer after using baby powder and other talc products for decades.
Their lawyers alleged the company knew its talcum powder was contaminated with asbestos since the 1970s but failed to warn consumers about the risks.
The company denied that its products ever contained asbestos and insisted that they do not cause cancer.
The pharmaceutical giant added that several studies have shown its talcum powder to be safe and insisted the verdict was a product of a “fundamentally unfair process”.
The verdict is the largest payout J&J has faced over allegations its talc products cause cancer.
A previous ruling in 2017 by a California jury awarded $417m (£323.4m) to a woman who said she developed ovarian cancer after using the firm’s products including baby powder.
However, a judge later overturned that verdict and several other legal challenges by J&J are yet to be decided.
Punitive damages are often reduced by the trial judge or on appeal, and J&J has succeeded in having several jury verdicts overturned, some of them on technical grounds.