The era of “big data” presents a unique opportunity to optimize precision medicine in interstitial lung disease (ILD). In this chapter, we explore three distinct epochs of big data in ILD research: Epoch 1, characterized by epidemiological and observational studies; Epoch 2, our current era of high-dimensional multimodal data integration; and Epoch 3, a future state that moves precision medicine from the theoretical research domain into real-time clinical implementation. To transition from Epoch 2 to 3, several challenges must be addressed including issues of data quality and harmonization, computational limitations, privacy, and equity concerns. Key priorities for advancing precision medicine in ILD include improving data integration, developing advanced analytic tools to analyze large volumes of data, expanding exposome research, therapeutic development, and translating findings into clinical care. Actualizing this potential requires researchers, clinicians, patients, and policy-makers to make a consorted effort to invest in the data infrastructure, collaborations, diverse patient inclusion, human-centered design, and comprehensive training programs that ensure engagement with emerging tools at the point-of-care delivery. By addressing these priorities, we can usher in a new era of precision medicine in ILD, ensuring delivery of the right care to the right patient at the right time.