Abstract: Drug-induced interstitial lung disease (DI-ILD) is the most common form of drug-induced pulmonary adverse events, with anticancer drugs being the primary cause. DI-ILD first gained attention as a notable adverse event due to the use of antibody-drug conjugates (ADC). As the development of drugs, particularly ADCs, continues to expand and more ADCs are approved or nearing approved for clinical use, DI-ILD has become an area of growing concern. However, the mechanisms by which ADCs induce ILD remain unclear. This article reviews the mechanisms of DI-ILD in the most commonly used ADCs targeting human epidermal growth factor receptor 2 (HER2).