Using the fixed-effects model and IV method for analysis, the pooled results revealed that ferritin (>336 ng/mL) (OR = 5.844, 95% CI: 4.121–8.287, p < 0.001), CRP (>0.05 mg/L) (OR = 3.366, 95% CI: 2.149–5.274, p < 0.001), LDH (>280 U/L) (OR = 3.627, 95% CI: 2.406–5.466, p < 0.001), ESR (>21 mm/h) (OR = 1.598, 95% CI: 1.089–2.344, p = 0.016), AST (>36 U/L) (OR = 2.666, 95% CI: 1.864–3.814, p < 0.001), and ALT (>27.75 U/L) (OR = 2.702, 95% CI: 1.737–4.201, p < 0.001) were associated risk factors for RP-ILD development in IIM patients. The gene discussed is ESR1; the disease is interstitial lung disease.