Complex immune-mediated conditions such as granulomatosis with polyangiitis, systemic lupus erythematosus, and rheumatoid lung disease fall under autoimmune/vasculitic lung disease. These disorders present diverse pulmonary manifestations, from interstitial involvement and nodules to diffuse alveolar hemorrhage. Timely recognition and immunosuppressive therapy are critical in preventing irreversible lung damage. Diagnostic approaches often rely on high-resolution CT, bronchoscopy, and serologic panels to distinguish overlapping pathologies. Autoimmune/vasculitic lung disease also highlights the role of biologics, including B-cell depleting agents and JAK inhibitors, in targeting inflammatory cascades. Managing these patients requires a careful balance between infection risk and immunomodulation. Integrating rheumatologic expertise and pulmonary rehabilitation into long-term care frameworks is essential to preserve function and improve prognosis.