To the Editors: Lung function abnormalities are often present when patients are first diagnosed with pulmonary sarcoidosis, and most studies to date indicate that the predominant pattern is of restriction or normal airways, with a truly obstructive pattern in a minority [1]. The largest case–control study of sarcoidosis to date, the ACCESS (A Case Control Etiologic Study of Sarcoidosis) trial, showed that the biggest group of patients in that particular cohort (46.9%) presented with a forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio of >80% and only 13.2% presented with a ratio of 50–69% [2]. Of the 215 patients from the ACCESS trial who were followed up for a further 2 yrs, the majority showed no change in pulmonary function, radiographic stage or dyspnoea score [3]. A more recent European study showed that patients with sarcoidosis had impaired lung compliance and a reduced diffusing capacity of the lung for carbon monoxide ( D L,CO) and, while there was no predominance of restrictive lung defects, airway obstruction was only present in 11.7% of patients [4]. Over the past 3 yrs, we have noticed that an increasing number of patients who present to our clinics in West London, UK with a new diagnosis of pulmonary sarcoidosis have a predominantly obstructive lung defect. A detailed analysis of lung function in sarcoidosis with respect to stratification by patient demographics has, to our knowledge, not been previously reported. We present the results of a systematic retrospective analysis of 164 consecutive patients presenting with a new diagnosis of pulmonary sarcoidosis over a 10-yr period and in whom formal lung function was recorded at the time of presentation. All patients had a clinically definite diagnosis, with supportive histology …