Much has been learned over the last decade about the genetic predisposition to different patterns of sarcoidosis and its pathogenesis. These major advances have been possible through the very rapid evolution of newer molecular technology. The last two years have also seen the publication of an international statement on sarcoidosis that defines very clearly the presentation, clinical features, diagnosis and treatment of sarcoidosis and also clearly identifies areas where we need to know more. This review aims to highlight key issues that have emerged over the last five years. Specific focus is given to genetic predisposition and trigger factors-molecular epidemiology. The more novel approaches that have been taken to attempt to treat this disease more effectively are also addressed.