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Did you flatten the image before saving to PDF?
Did you use the high quality Print preset?
Are your layers vector where possible? Certainly all lines can be vector (Shape) layers.
What was the image size in pixels?
I did flatten the image & used high quality Print preset.
My layers (lines) are not vectors. Assume this could be the problem. Could you help me understand that or point me to some helpful information about this? (My illustration is mostly looking fine, but it has black outlines, which are what is coming out pixelated. I think turning these into vectors may help? I tried image trace on Illustrator but it wasn't precise enough.)
The image size is 64.2M. In pixels: 6600 x 2550.
Try to view at 100%. Still pixelated?
There should be plenty enough pixels here, so maybe it's an on-screen scaling artifact. 100% view is the only entirely accurate display. It maps one image pixel to exactly one screen pixel.
Unfortunately, it is at 100% and my lines are still not smooth enough. I think they may need to be vectors. Any ideas on how to make lines smoother in photoshop?