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Background and Aim of Work: Although sarcoidosis is a multisystem disease, mortality from sarcoidosis is usually due to respiratory failure. In order to identify those patients at risk of death from respiratory failure from sarcoidosis, we analyzed a seven-year experience of patients seen at the University of Cincinnati Interstitial Lung Disease clinic., Results: A total of 479 patients were seen during that time. Of these, 22 (4.6%) died. Thirteen patients died from respiratory failure, three died from cardiac disease, and two each from neurologic or hepatic disease. Two patients died from unrelated disease. Analysis of the patients who died from respiratory failure was compared to the other patients. All patients who died from respiratory failure had fibrotic changes demonstrated by chest roentgenogram. All patients who died had at least one vital capacity less than 2.5 liters, with the majority of patients who died of respiratory failure having a vital capacity of less than 1.5 liters., Conclusions: Patients who die from respiratory failure from their sarcoidosis have fibrosis demonstrated on chest roentgenogram and a reduced vital capacity, usually less than 1.5 liters.