Childhood interstitial lung diseases (chILD) are a rare presentation. We report case of siblings diagnosed with combined pulmonary fibrosis and emphysema (CPFE) attributable to ABCA 3 mutation. It highlights the progressive nature of the disease as it unfolds itself in both the siblings at around the same age. This is the second case of chILD with CPFE reported in literature and the first evidence of its occurrence in siblings adds to the novelty.