INTRODUCTION Interstitial lung disease (ILD) is common in patients with primary Sjogren syndrome (pSS). Pulmonary fibrosis significantly reduces the patient's quality of life. Therefore, better understand-ing of the characteristics of patients with pulmonary fibrosis is necessary.OBJECTIVES The aim of the study was to evaluate the computed tomography (CT) and clinical features of pSS -related ILD and to explore the factors associated with fibrotic ILD in patients with pSS. PATIENTS AND METHODS In total, 151 patients with pSS-related ILD were retrospectively studied for their demographic and clinical characteristics. The patients were categorized into the nonfibrosing ILD and fibrosing ILD groups based on their CT findings. The clinicl, laboratory, and CT findings from both groups were compared to determine the influencing factors associated with the condition. RESULTS The nonfibrosing ILD and fibrosing ILD groups comprised 103 and 48 patients, respectively. As compared with the nonfibrosing ILD group, the fibrosing ILD group had a shorter disease duration, higher frequency of dry cough and shortness of breath, more patients with ground-glass opacity, mediastinal lymph node disease, and pleural lesions on chest CT, and lower frequency of dry mouth and eyes. Dry cough and shortness of breath were independent predictors of pulmonary fibrosis in the patients with pSS (P = 0.01 and P = 0.02, respectively).CONCLUSIONS The presence of dry cough and shortness of breath in the patients with pSS may indicate concomitant pulmonary fibrosis. High-resolution chest CT can be used for better insights on the occur-rence and severity of pulmonary fibrosis in these patients.