Background　In the ICU setting， the incidence of acute respiratory distress syndrome（ARDS） is 7%-10%.Reported mortality rate is still high，ranged from 36%-44%. Ventilation strategies for ARDS is the prime focus in management.　Objective　This review emphasizes progress of mechanical ventilation strategy for ARDS.　Content　Lung protective ventilation strategies for ARDS includs low tidal volums（4 ml/kg-7 ml/kg），low plateau pressures［＜28 cmH2O-32 cmH2O（1 cmH2O=0.098 kPa）］， permissive hypercapnia and the optimal level of positive end expiratory pressure. Oxygenation，pulmonary mechanical characteristics and study of lung imaging can help clinicians titrate positive end expiratory pressure better， although the optimal level of positive end expiratory pressure when ventilating patients with ARDS remains unclear. Lung recruitment maneuver is a necessary complement to open lung strategy of lung protective ventilation methods for ARDS patients with refractory hypoxemia， but the pulmonary recruitability must be assessed. The effect of lung recruitment maneuver influenced by etiology and the course of ARDS. Recent study support the existence of a survival benefit with prone positioning ventilation in severely hypoxemia ARDS patients. The pulmonary imaging， the course of ARDS and the severity hypoxemia can help predict the reaction to prone positioning ventilation.　Trend　In the future， extracorporealmembrane oxygenation may be the first-line choice for respiratory support to severe patients with ARDS who are unsuitable for conventional therapy.