Abstract : Persistent respiratory symptoms and residual lung abnormalities are commonly observed after acute SARS-CoV-2 infection. In a subset of patients, these abnormalities meet criteria for post-COVID interstitial lung disease (post-COVID ILD), encompassing a spectrum from resolving inflammatory changes to established fibrotic remodeling. To summarize current evidence regarding definitions, epidemiology, clinical spectrum, and pathophysiological mechanisms of post-COVID ILD, providing a framework for subsequent diagnostic and therapeutic decision-making. A narrative review of peer-reviewed literature published between 2022 and 2025 was conducted using major medical databases. International consensus statements, clinical guidelines, and longitudinal cohort studies addressing post-COVID lung involvement were analyzed. Most post-COVID parenchymal lung abnormalities improve or stabilize over time. Persistent disease is more frequently observed after severe COVID-19 pneumonia and is associated with impaired gas exchange. Distinct clinical and radiologic phenotypes of post-COVID ILD can be identified, which have important prognostic implications. Post-COVID ILD represents a heterogeneous condition rather than a single disease entity. Careful phenotyping and longitudinal assessment are essential to avoid overtreatment and to identify the minority of patients at risk of progressive fibrotic disease.