Inflammatory myopathies are a group of autoimmune diseases characterised by chronic muscle inflammation and weakness, primarily affecting proximal muscles. The major subtypes include polymyositis, dermatomyositis, inclusion body myositis and necrotising autoimmune myopathy. Diagnosis is most of the times a difficult task due to overlapping symptoms, such as muscle weakness and fatigue, shared with other neuromuscular and systemic diseases. Misdiagnosis often delays appropriate treatment, particularly in inclusion body myositis, which is resistant to corticosteroids and mimics conditions like sarcopenia or motor neuron disease. Diagnostic pitfalls include limitations of serologic tests, such as creatine kinase levels and myositis-specific antibodies, as well as challenges in muscle biopsy interpretation. Additionally, extramuscular manifestations, such as interstitial lung disease and cardiac involvement, are frequently under-recognised, leading to suboptimal management. Comprehensive care requires a multidisciplinary approach, combining clinical assessment with advanced diagnostics and tailored therapies. Early recognition and intervention are crucial to improving outcomes and preventing irreversible muscle and systemic damage.