Idiopathic lung fibrosis is a chronic disease affecting the pulmonary interstitium or parenchyma. As such it has signs typical of other interstitial lung diseases such as dyspnea, hypoxia, chronic cough and clubbing of fingers. It typically affects older patients with a history of smoking or exposure to some occupational pollutants as well as patients with a positive family history. Multiple hypotheses are present that would explain this condition, including both genetic factors and environmental factors such as smoking or air pollutants. It is safe to say that this disease is caused by an interplay of various factors and not one single cause. It is a relatively rare disease with a very poor prognosis. Diagnosis is complex and involves a multidisciplinary approach. In addition to proper anamnesis and physical exam other more advanced procedures such as high-resolution computerized tomography imaging. Cryobiopsy and bronchoalveolar lavage are also needed for excluding differentials and for establishing a diagnosis. Important treatment breakthroughs have been made in recent decades owing to newly discovered antifibrotic drugs. These have greatly impacted our treatment procedures for idiopathic lung fibrosis, by helping to prologue life and improve symptoms. Because of this they have injected a newfound optimism into treatment of this difficult condition. Another important consideration in idiopathic lung fibrosis are the various comorbidities associated with this condition. As with most chronic conditions we have numerous comorbidities such as lung cancer, esophageal reflux, heart failure and pulmonary embolism that must be recognized and treated because they can significantly alter the patient’s outcome.