Electrical impedance tomography (EIT) has the advantages of being bedside, non‑invasive, non‑radiation, and dynamic functional imaging. It can assess global and regional lung ventilation and perfusion, and evaluate the differences between different regions in the lungs, in order to optimize respiratory therapy and formulate individualized management. This article reviews the principle of EIT monitoring, the parameters commonly used in monitoring lung ventilation and perfusion, and its application in adults with acute respiratory distress syndrome, including nasal high‑flow oxygen therapy, mechanical ventilation (titration of positive end‑expiratory pressure, lung recruitment maneuvers and withdrawal of ventilator supports), prone positioning, and veno‑venous extracorporeal membrane oxygenation, in order to provide reference for clinical practice.