Abstract: Objective To investigate the clinical and imaging features of patients with primary Sjogren's syndrome (pSS) complicated with interstitial lung disease (ILD). Methods The clinical and imaging data of 148 cases of pSS were reviewed in last 6 years. Thirty nine patients with -ILD were assigned into ILD group, and 109 patients with pSS without ILD into the control group. The clinical manifestations, immunological parameters and lung function were compared between the two groups. The imaging findings in ILD group were studied. Results ①The mean age and age of onset in the ILD group were significantly higher than those in the control group (P<0.05). ②The incidence of dry cough, shortness of breath, fatigue and psychiatric symptoms in ILD group was significantly higher than that the control group (all P<0.05). ③The positive rates of ANA, anti-SSA antibody and rheumatoid factor in ILD group were higher than those in the control group, the difference was statistically significant (all P<0.05). ④DLCO% of the predicted value in the ILD group was significantly lower than that in the control group (P<0.05). The mean pulmonary artery pressure and the proportion of pulmonary hypertension in the ILD group were higher than those in the control group (all P<0.05). ⑤Ground-glass opacity was the most common manifestation in ILD group, followed by mesh shadow and traction bronchiectasis. Conclusion ILD was a common manifestation of pSS with various clinical manifestations. The serum antinuclear antibody, anti-SSA antibody and rheumatoid factor positive rate were higher in pSS-ILD patients. The incidence of pulmonary hypertension was higher in pSS-ILD patients. Ground-glass opacity was the most common manifestation in pSS-ILD patients.