Background: Interstitial Lung Disease (ILD) comprises a diverse group of parenchymal lung disorders characterized by inflammation, fibrosis, and progressive respiratory impairment. It represents a rising global health challenge, with significant burden in India due to occupational exposures, biomass fuels, tuberculosis sequelae, and post-COVID fibrosis.

Objective: To provide a comprehensive clinical and public health perspective on ILD, including its pathology, epidemiology, diagnostic strategies, management across etiologies and severity, occupational health implications, and preventive measures.

Methods: A narrative academic review synthesizing current literature, clinical guidelines, and case-based experiences. Special emphasis is placed on diagnostic assessment, pharmacologic and non-pharmacologic management, occupational ILDs, and post-infectious sequelae such as pulmonary tuberculosis and COVID-19.

Results: ILDs present with overlapping features but require precise diagnostic tools such as high-resolution computed tomography (HRCT), pulmonary function tests, and multidisciplinary discussions. Antifibrotic therapies (pirfenidone, nintedanib) have improved outcomes in idiopathic pulmonary fibrosis, while corticosteroids and immunosuppressants remain central for hypersensitivity pneumonitis and connective tissue disease–associated ILD. Occupational ILDs (silicosis, asbestosis, byssinosis, farmer’s lung) remain prevalent and underdiagnosed, necessitating preventive workplace interventions. Post-infectious sequelae, particularly after TB, pneumonia, and COVID-19, are emerging contributors to the ILD burden. Early recognition, exposure control, pulmonary rehabilitation, and multidisciplinary care improve prognosis.