Thoracic sarcoidosis is a common disease, and its usual radiographic manifestations have been well described and are readily recognized. However, most physicians are not familiar with the unusual and often confusing manifestations of thoracic sarcoid, which have been sporadically reported. Using information derived from a systematic review of the literature and clinical material from our own institutions, a classification has been developed of the unusual thoracic manifestations of sarcoidosis, and their relative incidence has been determined and tabulated. These include lesions of the osseous, pleural, mediastinal, hilar, bronchial, pulmonary parenchymal, vascular, and cardiac structures. The information presented in this review is intended to provide physicians with a single comprehensive source to assist them when atypical radiographic findings of thoracic sarcoidosis are a diagnostic consideration.