In Korean medicine, the lungs and kidneys are viewed as interconnected organs essential for fluid metabolism and respiratory function. The lungs are described as the "upper source of water," dispersing body fluids and qi (vital energy) throughout the body, while the kidneys anchor and store qi. Both traditional and modern medicine recognize that dysfunction in one organ can lead to impairment in the other, with numerous cases illustrating concurrent decline in kidney function in pulmonary diseases and vice versa.This review examines and contrasts lung-kidney interactions as conceptualized in Korean and modern medicine, focusing on their roles in respiration, fluid balance, and immune response. We analyze the physiological basis of lung and kidney interdependence, utilizing traditional theories from Korean medicine alongside findings from modern clinical research. In Korean medicine, the lung-kidney relationship is characterized by a mutual dependence that supports homeostasis in both respiration and fluid regulation. Pathological observations, such as those in chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD), confirm the modern understanding that these organs share roles in acid-base balance, blood pressure control, and fluid metabolism. Autoimmune diseases, such as systemic lupus erythematosus (SLE) and ANCA-associated vasculitis, also commonly impact both organs, demonstrating immune system-mediated injury in both the lungs and kidneys. Our findings underscore the importance of a combined therapeutic approach that considers both lung and kidney function in treating diseases affecting either organ. Korean medicine’s integrated perspective on lung and kidney interaction aligns with modern medical research, which supports the need for cross-disciplinary treatment strategies. Future research should explore the mechanisms of lung-kidney interaction further to enhance understanding of disease progression and treatment efficacy. This study highlights the physiological and pathological interactions between the lungs and kidneys, presenting an integrated framework that bridges traditional Korean medicine and contemporary clinical insights. Understanding these interdependencies will help develop comprehensive treatment strategies for patients experiencing simultaneous lung and kidney dysfunction.