【Abstract】 Sepsis‑induced acute lung injury (ALI) is a rapid onset, typical clinical intensive emergency. Studies have shown that mitochondrial dynamics, endoplasmic reticulum stress (ERs), Golgi apparatus stress, lysosome‑mediated autophagy, exosome secretion and transfer play an essential role in the pathophysiological process of septic ALI. Heme oxygenase‑1 (HO‑1) and its catalytic byproducts, carbon monoxide (CO), are one of the crucial endogenous protective mechanisms of cells under stress, which can alleviate septic ALI through antioxidant, anti‑inflammatory, and anti‑apoptosis effects. This review mainly elaborates the role of HO‑1/CO system in regulating the intracellular key organelles such as mitochondria, endoplasmic reticulum, golgi apparatus, lysosome, exosome in the settings of septic ALI, which provides a new approach and theoretical basis for the prevention and treatment of septic ALI.