High-resolution CT (HRCT) is the radiological imaging technique that most closely reflects changes in lung structure. It represents the radiological method of choice for the diagnostic work-up of patients with known or suspected diffuse interstitial lung disease. A single HRCT finding is frequently nonspecific, but the combination of the various HRCT findings together with their anatomic distribution can suggest the most probable diagnosis. The purpose of this article is to summarize the classic HRCT features of the most common diffuse interstitial lung diseases. Lists of differential diagnoses and distinguishing key features are provided to improve diagnostic confidence. The presence of classic HRCT features often obviates the need for biopsy. In patients with atypical findings, HRCT can be used to determine the most appropriate biopsy site.