Today, we have available both diagnostic tools and potential options for treatment, including specific pharmacologic therapies and transplantation. Interest in sarcoidosis-associated PH, as well as a host of other nonidiopathic causes of elevated PAPs, has burgeoned. Despite the increased attention, a frequent rejoinder has been that mild elevations of PAPs are just a reflection of advanced disease. Thus, the findings reported by Baughman et al6 in this issue of CHEST (see page 1078) represent an extremely provocative step forward in our understanding of the significance of sarcoidosis-associated PH. Beyond its obvious prognostic implications, the study invites consideration of the possibility of screening subsets of patients with sarcoidosis for sarcoidosis-associated PH. Further, it suggests that invasive testing, not echocardiography, is necessary when sarcoidosis-associated PH is suspected. Finally, by linking prognosis to physiology, this article implies that mechanisms leading to pulmonary vascular pathology in sarcoidosis may be important therapeutic targets.