Objective To explore the correlation of traditional Chinese medicine (TCM) syndrome types with chest high resolution computed tomography (HRCT) stages and scores and pulmonary function of interstitial lung disease (ILD). Methods The TCM syndrome types, chest HRCT image stages and scores and pulmonary function results of 259 ILD patients were retrospectively analyzed to explore the relationship between the 3 factors. Results Early ILD patients according to HRCT staging had a high proportion of excess syndrome; the proportion of deficiency syndrome in the middle and late stage patients increased gradually, and the latter was mainly characterized by deficiency of both lung and kidney qi and yin and deficiency of lung and kidney qi, accounting for 30.2% (13/43) and 20.9% (9/43), respectively. The HRCT scores of patients with deficiency of both lung and kidney qi and yin and deficiency of lung and kidney qi were the highest (18.67±2.64 and 14.06±2.28, respectively), which were significantly different from those of other TCM syndrome types (all P＜0.01). The forced vital capacity (FVC) as a percentage of predicted (FVC%pred) and diffusing capacity for carbon monoxide of lung (DLCO) as a percentage of predicted (DLCO%pred) of the ILD patients with both deficiency of lung and kidney qi and yin and deficiency of lung and kidney qi were the lowest, which were significantly different compared with the patients with other TCM syndrome types (P＜0.01, P＜0.05). HRCT score was strongly negatively correlated with DLCO%pred (r＝－0.695, P＜0.01), moderately negatively correlated with FVC%pred and forced expiratory volume in one second (FEV₁) as a percentage of predicted (r＝－0.468, －0.402, both P＜0.01), weakly negatively correlated with FEV₁/FVCpred as a percentage of predicted and DLCO/alveolar ventilation as a percentage of predicted (r＝－0.364, －0.294, both P＜0.01), and very weakly negatively correlated with total lung volume as a percentage of predicted (r＝－0.116, P＜0.01). Conclusion There is a certain relationship between TCM syndrome types, HRCT stages and scores, and pulmonary function in patients with ILD. The HRCT stage and score of the patients with lung and kidney _qi and _yin deficiency syndrome or lung and kidney _qi deficiency syndrome are the highest, and their pulmonary function is the worst.