Novel diagnostic techniques in interstitial lung disease (ILD) are shifting the compass toward increased precision, targeted therapeutics, and improved patient outcomes. Cryobiopsy, which was originally proposed for the diagnosis of endobronchial lesions, has expanding application in ILD diagnosis due to limitations of conventional sampling techniques including small biopsy size and the presence of artifacts. The genomic classifier represents another option to determine a molecular usual interstitial pneumonia (UIP) signature to facilitate an ILD diagnosis. In recent years, optical coherence tomography (OCT) and confocal laser endomicroscopy (CLE) are imaging techniques which provide microscopic images in vivo during bronchoscopy and may increase diagnostic accuracy in ILD. This chapter provides a comprehensive overview of the current evidence regarding evolving bronchoscopic diagnostic methods in ILD and considers their future role in routine clinical care.