The accurate diagnosis of IPF may be very challenging and is associated with significant prognostic and therapeutic implications. Expert consensus guidelines for the diagnosis of IPF from 2011 recommend 1) confirmation of a UIP pattern either radiologically and/or histopathologically, and 2) exclusion of other known causes of ILD. This is much easier said than done in real world clinical practice. In this session, I will discuss multiple existing challenges ranging from the diagnostic disagreement of IPF between community and academic physicians, availability and accessibility of expert radiologists and pathologists, a pragmatic way of ruling out alternative diagnoses (e.g., CTD-ILD and HP), and essential participation in a multidisciplinary discussion.