The complexity of the lung injury in acute respiratory distress syndrome (ARDS) compels the use of 3-dimensional imaging tools, such as computed tomography, lung ultrasounds, electrical impedance tomography or positron emission tomography, capable of capturing heterogeneity from apex to lung base, and accounting for the spatial distribution of aeration, ventilation and perfusion. Lung imaging, be it in the experimental setting, or at the bedside of critically ill patients with ARDS, has led to major advances in the understanding and management of the syndrome, and has the potential to guide ventilatory and non-ventilatory strategies in the near future