Chest imaging has a central role in the diagnosis and monitoring of sarcoidosis. For staging of pulmonary disease on chest radiograph, Scadding stages are still widely used. High-resolution CT (HRCT), however, is more accurate in visualizing the various manifestations of pulmonary sarcoidosis as well its complications. A generally accepted HRCT scoring system is lacking. Fluorodeoxyglucose F 18 positron emission tomography can visualize disease activity better than conventional makers in a significant proportion of patients. In patients with extensive changes on HRCT but no parenchymal fluorodeoxyglucose F 18 uptake, prudence with regard to initiation or intensification of immunosuppressive treatment is warranted.