Sarcoidosis is a systemic granulomatous disease of unknown origin, characterised by the formation of non-caseating granulomas in multiple organs. It poses significant diagnostic and management challenges due to its ability to mimic other autoimmune diseases, reliance on non-specific biomarkers and varied systemic manifestations. The disease often presents with overlapping symptoms, such as symmetric polyarthritis, sicca syndrome or skin rashes, mimicking rheumatoid arthritis, Sjögren’s syndrome or systemic lupus erythematosus, respectively. A comprehensive evaluation, including imaging, tissue biopsy to confirm non-caseating granulomas, is essential for accurate diagnosis. Serum angiotensin-converting enzyme levels are a common pitfall, as elevated levels are non-specific and absent in some cases. Rheumatologists must also recognise extrapulmonary manifestations, including musculoskeletal, cutaneous, ocular, cardiac and neurologic involvement, which are frequently underdiagnosed. Baseline organ screening using pulmonary function tests, high-resolution computed tomography, ophthalmologic exams, heart exams and kidney function tests is crucial to assess the disease extent. Mismanagement of corticosteroid therapy, whether through overtreatment or undertreatment, can result in unnecessary side effects or irreversible damage. Individualised treatment plans, including the use of steroid-sparing agents and close monitoring of therapy side effects, are critical for optimal patient outcomes.