This manuscript offers an approach to the treatment of pulmonary sarcoidosis based on current available information. The treatment of pulmonary sarcoidosis is not mandatory as the disease may be self-limiting and therapy is often associated with significant drug side effects. The decision to treat rests predominantly on the presence of significant symptoms or functional limitation. Corticosteroids are the drug of choice. Alternative agents to corticosteroids may be useful primarily as corticosteroid sparing agents.