Abstract: Acute respiratory distress syndrome remains a common critical disease of respiratory system. The main clinical treatments are mechanical ventilation and fluid management. To date, the lack of effective treatment measures still exists in clinical practice. In recent years, mesenchymal stem cell-based therapy for treating acute respiratory distress syndrome has become a hotspot for research. This article will illustrate the possible mechanism and research progresses of mesenchymal stem cell-based therapy for curing acute respiratory distress syndrome from the perspectives of homing and differentiation, paracrine, regulation of inflammation factors and macrophage polarization as well as optimization of curative effect through gene modification. The brief introduction of the course for the future and the prospect in clinical application concerning this emerging therapy is also included.