Invasive pulmonary aspergillosis (IPA) is a severe fungal infection caused by *Aspergillus* species, characterized by the invasion of pulmonary tissue. The disease spectrum ranges from colonization to deep tissue penetration and angio-invasion, depending on the host's immune status. Patients with prolonged severe neutropenia and those with graft-versus-host disease are at high risk, but IPA also occurs in immunocompromised and nonimmunocompromised patients, including those with solid organ transplants or severe viral infections. Diagnosis of IPA is challenging and often requires a combination of clinical, radiological, and mycological features. Triazoles are the first-line treatment, and the choice of drug should be individualized. Adjunctive immunomodulatory therapy may be considered. Despite advancements in diagnosis and treatment, IPA remains a significant burden with high mortality. This review provides a comprehensive overview of the epidemiology, clinical presentation, diagnosis, and treatment of acute IPA, emphasizing the importance of early and accurate diagnosis and prompt antifungal therapy.Invasive pulmonary aspergillosis (IPA) is a severe fungal infection caused by *Aspergillus* species, characterized by the invasion of pulmonary tissue. The disease spectrum ranges from colonization to deep tissue penetration and angio-invasion, depending on the host's immune status. Patients with prolonged severe neutropenia and those with graft-versus-host disease are at high risk, but IPA also occurs in immunocompromised and nonimmunocompromised patients, including those with solid organ transplants or severe viral infections. Diagnosis of IPA is challenging and often requires a combination of clinical, radiological, and mycological features. Triazoles are the first-line treatment, and the choice of drug should be individualized. Adjunctive immunomodulatory therapy may be considered. Despite advancements in diagnosis and treatment, IPA remains a significant burden with high mortality. This review provides a comprehensive overview of the epidemiology, clinical presentation, diagnosis, and treatment of acute IPA, emphasizing the importance of early and accurate diagnosis and prompt antifungal therapy.