Aim. To assess cytokine spectrum changes in different types of pulmonary sarcoidosis (PS). Subjects and methods. Twenty-seven PS patients without signs of pulmonary fibrosis and 14 patients with sarcoidosis complicated by pulmonary fibrosis were examined. Baseline serum Th1 and Th2 cytokine concentrations were studied. A control group comprised 30 healthy donors. Results. A higher interleukin (IL)-4/IL-2 ratio was found in the peripheral blood of the patients with pulmonary fibrosis-complicated sarcoidosis than in the other patients (326.4±122.6 and 88.2±28.6%, respectively; р=0.002). The sarcoidosis patients with signs of pulmonary fibrosis and no symptoms of disease inflammatory activity had elevated blood IL-1 levels whereas an IL-1 receptor antagonist was decreased. Conclusion. In the patients with PS, the development and progression of pulmonary fibrosis occur with a shift in the Th1/Th2 balance towards Th2, which manifests itself as a higher IL-4/IL-2 ratio in the peripheral blood. At the same time, the signs of systemic inflammatory activity remain.