Interstitial lung abnormalities (ILA) are incidental radiological findings on CT that may signal early or future interstitial lung disease (ILD) but do not meet its specific criteria at the time of detection. These are subclinical changes that occur more frequently in older smokers undergoing CT scans for reasons other than lung or heart cancer screenings. The prevalence of ILA is increasing due to an aging population and greater awareness among younger patients. The article summarizes the definitions of ILA, their epidemiology, risk stratification and management. It emphasizes the interest in risk factors for the development and progression of ILA in order to optimize ILD outcomes. It outlines the current challenges and gaps in knowledge about these abnormalities.