The CD103+ integrin is an adhesion molecule found on > 95% of intra-epithelial mucosal lymphocytes, but on <2% of circulating lymphocytes. Several studies have shown that the proportion of CD4+ lymphocytes expressing the CD103+ integrin (CD103+CD4+/CD4+ ratio) in bronchoalveolar lavage fluid (BALF) was low in sarcoidosis compared to other interstitial lung diseases, but we previously demonstrated that the difference was insufficient to allow a confident diagnosis of sarcoidosis without tissue biopsy. Whether BALF CD103+CD4+/CD4+ ratio could have prognostic value in sarcoidosis is unknown. To address this issue, we examined the associations between BALF CD103+CD4+/CD4+ ratio and clinical and imaging characteristics in a retrospective series of 115 patients with sarcoidosis. 63% were men, with a median age of 48 years. 47% had radiographic stage I, 49% had stage II, and 4% had stage III or IV. The median BALF lymphocyte count was 43% and the median CD103+CD4+/CD4+ ratio was 17%. A higher CD103+CD4+/CD4+ ratio was significantly associated with a higher radiographic stage at diagnosis (p=0.017) and last visit (p<0.0001), as well as the presence of fibrosis at imaging at diagnosis (p=0.043) and last visit (p=0.032). Besides an inverse correlation with forced vital capacity at diagnosis (β=-0.16, p=0.031), no consistent association was found between the BALF CD103+CD4+/CD4+ ratio at diagnosis and lung function parameters at diagnosis and last visit. We conclude that BALF CD103+CD4+/CD4+ ratio may have prognostic value in sarcoidosis.