There are several medical conditions that directly or indirectly lead to pulmonary destruction or acute lung injury or Acute Respiratory Distress Syndrome e.g. Sepsis, Inhalation of harmful substances, severe pneumonia, Head, chest, or another major injury, Pancreatitis (inflammation of the pancreas), massive blood transfusions and burns. Due to some incidences involved in the etiology of ARDS and limited information about the epidemiology, recognition, management, and less significant results regarding patients with acute respiratory distress syndrome (ARDS), shows intense research on ARDS is needed. From an earlier time, this syndrome has been given many names, including congestive atelectasis, traumatic adult respiratory distress syndrome and shock lung. Recently, the new definition of ARDS has been published, and this definition suggested severity-oriented respiratory treatment by introducing three levels of severity consistent with PaO2/FiO2 and positive end-expiratory pressure. Lung-protective ventilation is still the key to a better outcome in ARDS. ARDS is said to a selection of etiologies, carries high morbidity, mortality (10to 90%), and financial cost. This review is an attempt to compile all aspects of the management of ARDS.