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Introduction Bronchoalveolar lavage (BAL) differential cellular analysis may be a valuable tool in the diagnostic evaluation of patients with Interstitial Lung Disease (ILD), with international consensus guidelines typically recommending consideration in those without a definite Usual Interstitial Pneumonia pattern on HRCT, however the practical utility continues to be debated. 1 Method A single centre retrospective casenote review of patients undergoing BAL as part of ILD diagnostic workup.Results 36 patients underwent BAL between January 2022 and June 2025. 22 (61.1%) were female and median age was 66 years. 19 (52.7%) were ex-smokers with 13 (36.1%) non-smokers and 2 (5.5%) current smokers. The mean smoking pack year history was 21.3 years. BAL was generally well tolerated with no significant complications; 2 patients (5.5%) experienced minor complications with one experiencing hypoxia and subsequent early termination of the procedure; and one experiencing excessive coughing and discomfort.The most frequent diagnoses included acute hypersensitivity pneumonitis (25%), fibrotic hypersensitivity pneumonitis (19.4%) and connective tissue disease related ILD (8.3%). 3 patients (8.3%) had a diagnosis of unclassifiable ILD following BAL and subsequent discussion in an ILD MDT.31 (86.1%) of patients had their management influenced through BAL analysis. 11 patients (30.5%) were commenced on immunosuppression and 6 patients (16.6%) on anti-fibrotic medications.Conclusion Bronchoalveolar lavage was safe and influenced MDT discussion and management in the majority of patients in this selected cohort. Systems standardising the integration of BAL into cytopathology departments and ILD MDTs might further increase utility and therefore aid in the diagnostic pathway of interstitial lung diseases.Reference Meyer KC, Raghu G, Baughman RP, Brown KK, Costabel U, du Bois RM, Drent M, Haslam PL, Kim DS, Nagai S, Rottoli P, Saltini C, Selman M, Strange C, Wood B; American Thoracic Society Committee on BAL in Interstitial Lung Disease. An official American thoracic society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med. 2012;185(9):1004–14. doi: 10.1164/rccm.201202–0320ST. PMID: 22550210