Background: Interstitial pneumonias also called interstitial lung diseases (ILD) are a diverse group of over 100 diffuse parenchymal lung diseases often grouped together based on common clinical, radiological, and pathological characteristics. This study is sought to identify the etiology of the interstitial lung diseases in patients presenting to this tertiary care set up. Materials and methods: This was a prospective observational study, carried out at a tertiary care hospital from January 2021to June 2022. Adult patients presenting with respiratory symptoms and chest Xray findings suggestive of interstitial lung disease were screened further and checked for eligibility criteria. A total of 94 patients who met the eligibility criteria were subjected to routine diagnostic work up and HRCT chest to confirm the diagnosis. Results: This study revealed that Scleroderma was the most prevalent cause of ILD. CTD-ILD was the most common aetiology of ILD observed in this study.Additional causes included pneumoconiosis, smoking-related ILD, and hypersensitivity pneumonitis. Urban population (60.6%) made up the majority of participants, followed by suburban (23.4%) and rural (16%) populations. Conclusion: ILD is probably under reported in India, due to a lack of high-endfacilities, adequate awareness and clinical knowledge and appropriate testing at periphery. While CTD-ILD was shown to be the most prevalent cause in some Indian research, IPF was found to be the most common cause in others. According to this study, the most frequent cause of ILD in the local population presenting to this tertiary care institution is CTD-ILD.