The relationship between sepsis and the acute respiratory distress syndrome (ARDS) has been recognized for decades. Intense research since the syndrome was first described by Ashbaugh and his co-workers more than 30 years ago, has provided a better understanding of the definition, pathogenesis, and management of this syndrome. This article further elucidates the relationship between ARDS and sepsis. Different supportive modalities of mechanical ventilation and pharmacologic adjuncts for the management of sepsis-induced ARDS are also discussed.