Acute respiratory distress syndrome (ARDS) is characterized by acute lung injury and hypoxemia caused by a profound inflammatory response and diffuse alveolar damage. ARDS has an incidence of 5-71 per 100,000 people and costs $5 billion annually to treat in the US. Standard treatment focuses on treating the underlying cause, maintaining adequate oxygen levels through ventilator support using lung-protective strategies, and considering approaches like prone positioning to improve oxygenation. While mortality was historically high, outcomes have improved with application of evidence-based protocols, though ARDS still carries significant morbidity and risk of long-term complications.