Idiopathic pulmonary fibrosis is a chronic progressive fibrotic interstitial lung disease of unknown cause that primarily occurs in older adults. The patient presents with unexplained exertional dyspnoea, chronic dry cough or inspiratory velcro-like crackles on examination. Fibrosis is typically in the lower lobes of the lung. Clubbing , low oxygen saturation and dyspnoea is the hallmark of idiopathic pulmonary fibrosis. High resolution CT chest is cold standard for diagnosis. Here you see the pathological pattern of usual interstitial pneumonia: low base predominance, traction bronchiectasis, honeycombing and reticular changes without significance ground glass changes.