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Sarcoidosis is a multisystem disorder of uncertain etiology, characterized by non-caseating granuloma formation in the affected organs. Significant progress has been made in the understanding of the immunopathological aspects of this disease over recent years. However, the causative agent(s) remain unknown. There remains controversy around the best treatment regimens and duration of immunosuppressive therapy. This is largely related to the heterogeneity of disease, a paucity of large randomized controlled trials and the fact that a significant proportion of patients do not require treatment. This review aims to summarize the evidence for the management of pulmonary sarcoidosis and to provide an update on recent developments in diagnosis and treatment.