Background　Laparoscopic surgery has many advantages, such as mild trauma, rapid recovery and so on. But artificial CO2 pneumoperitoneum will increase the abdominal cavity pressure and cause acid-base balance disorder, leading to different degree of lung injury even acute respiratory distress syndrome(ARDS).　Objective　The review summarized the mechanism and new progress of prevention and treatment in lung injury caused by pneumoperitoneum.　Content　Mechanism of lung injury cause by pneumoperitoneum is complex, including imbalance of V/Q ratio, the oxidation/anti-oxidation system and pro-inflammatory/anti-inflammatory responses. Ischemia, hypoxia, ischemia-reperfusion injury may also involved. Combination of positive end expiratory pressure and small tidal volume, hypercapnia permission, pretreatment of pneumoperitoneum and the application of medicines can reduce the lung injury caused by pneumoperitoneum.　Trend　Advanced study on the mechanism of lung injury caused by CO2 pneumoperitoneum and therapeutic strategy provide new insights for prevention and treatment of pneumoperitoneum induced lung injury.