Gastroesophageal reflux (GER) has been associated with a number of interstitial lung diseases, including systemic sclerosis and idiopathic pulmonary fibrosis. Systemic sclerosis results in both pulmonary and esophageal manifestations, and studies have shown a correlation, but no causal relation, between GER and pulmonary fibrosis in this condition. The role of GER in idiopathic pulmonary fibrosis has recently been studied using esophageal pH monitoring, and the results show high prevalence of GER compared with normal individuals and patients with other interstitial lung diseases of known cause. Aggressive, long-term therapy of GER and evaluation of its effect on pulmonary disease will allow determination of the real influence of GER on idiopathic pulmonary fibrosis. Additional outcomes-based studies and therapeutic trials are needed to clarify the association between GER and interstitial lung diseases.