Diagnostic interventional pulmonology is widely accepted as a minimally invasive, highly accurate procedure for diagnosing lung cancer, more drug-resistant pathogen infections of lower respiratory tract, and critical respiratory diseases. The efficiency of interventional diagnostics depends on quite a few factors, including size and the anatomic location of lymph nodes, number of biopsy sites and complications rate, characteristics of the lesion, and underlying disease. Specifically, the application of rapid on-site evaluation (ROSE) may avoid additional sampling without compromising diagnostic yield with a preliminary evaluation for adequate diagnostic material and thus reduce the complication rate. In this review article we aimed at elaborate the technical details, clinical roles, and technological progress of ROSE in diagnostic interventional pulmonology, highlighting the importance of ROSE in diagnostic interventional pulmonology. We finally pointed out that it will be a tendency for a pulmonologist, to undergo a short yet intensive training and perform ROSE in diagnostic interventional pulmonology.