Abstract： Objective： To observe the clinical effect of acupuncture and moxibustion combined with individualized mechanical ventilation for acute respiratory distress syndrome(ARDS). Methods： A total of 96 cases of ARDS patients were divided into the control group and the observation group according to the random number table method， with 48 cases in each group. The control group was treated with individualized mechanical ventilation，and the observation group was additionally treated with acupuncture and moxibustion based on the treatment of the control group. The arterial blood gas， respiration parameters，lung injury and indexes of inflammatory responses before and after treatment and the clinical effects in the two groups were compared. The offline time， time of leaving intensive care unit(ICU)， incidence of ventilator- associated pneumonia(VAP) and mortality in the two groups were compared. Results：The total effective rate was 93.75% in the observation group，higher than that of 79.17% in the control group(P＜0.05). After treatment， the end- expiratory carbon dioxide partial pressure(PETCO2)， oxygenation index(PaO2/FiO2) and static compliance in the two groups were increased when compared with those before treatment， and the carbon dioxide partial pressure(PaCO2)， plateau pressure(Pplat) and positive end-expiratory pressure(PEEP) were decreased(P＜0.05). After treatment，the levels of pulmonary surfactant protein D(SP- D)，interleukin- 8(IL- 8)，high- sensitivity C- reactive protein(hs- CRP) and tumor necrosis factor- α(TNF- α) in the two groups were lower than those before treatment(P＜0.05)， and the levels of inflammatory factors in the observation group were lower than those in the control group(P＜0.05). The offline time and time of leaving ICU in the observation group were earlier than those in the control group (P＜0.05). There was no significant difference being found in the comparison of VAP incidences and mortality between the two groups(P＞0.05). Conclusion： Acupuncture and moxibustion combined with individualized mechanical ventilation can reduce inflammatory responses and lung injury， and improve prognosis and the clinical effect.