Background Intensive care unit-acquired weakness (ICU-AW) has constituted a frequent, severe, and persistent complication among critically ill patients admitted to ICU. ICU-AW is responsible for prolonged mechanical ventilation and ICU stay, and it may affect the long-term quality of life after discharge. Objective To investigate the pathophysiology, diagnosis and therapy of ICU-AW. Content Pathophysiology of sepsis and mechanical ventilation (MV) induced ICU-AW, and new concepts of diagnosis, prevention and management for ICU-AW will be reviewed. Trend Various aspects contribute to the management of ICU-AW, including early treatment of sepsis, shortening the duration of MV, appropriate drug treatment , early mobilization, and electrical muscle stimulation therapy.