Systemic sclerosis (SSc) is a connective tissue disorder with multiple organ involvement. Interstitial lung disease (ILD) is particularly significant as it is the leading cause of death in SSc patients. The clinical course of SSc-ILD is highly variable. It can progress rapidly or remain stable without treatment. Disease progression can occur both early and late in the course of the disease. This heterogeneity exemplifies the need to identify those who are at risk of developing ILD and those who are at risk of deterioration. In this article, we will review the latest evidence on the prevalence of SSc-ILD, the predictors of SSc-ILD development, and the risk factors for its progression.