This statement, a collaboration between the European Respiratory Society (ERS) and the European Society of Intensive Care Medicine (ESICM), reviews the prevalence, clinical significance, diagnosis, and management of dyspnoea in critically ill, mechanically ventilated adult patients. Dyspnoea is a distressing experience that can be worse than pain due to its association with the fear of dying. Approximately 40% of patients on invasive mechanical ventilation in the ICU report dyspnoea, with an average intensity of 45 mm on a visual analogue scale. The statement emphasizes the need for universal and specific consideration of dyspnoea, as it is often dissociated from clinical, radiological, or physiological abnormalities. It highlights the challenges in identifying and managing dyspnoea, particularly in mechanically ventilated patients who may have barriers to signaling their distress. The statement provides an operational definition of dyspnoea and discusses its pathophysiology, prevalence, and impact on patients. It also outlines methods for detecting dyspnoea, including self-reporting and observation scales, and suggests strategies for relief, such as reassurance and enhancing patients' sense of control. The statement aims to address the underestimation of dyspnoea and its consequences, including anxiety, poor sleep, weaning failure, and increased risk of post-traumatic stress disorder (PTSD).This statement, a collaboration between the European Respiratory Society (ERS) and the European Society of Intensive Care Medicine (ESICM), reviews the prevalence, clinical significance, diagnosis, and management of dyspnoea in critically ill, mechanically ventilated adult patients. Dyspnoea is a distressing experience that can be worse than pain due to its association with the fear of dying. Approximately 40% of patients on invasive mechanical ventilation in the ICU report dyspnoea, with an average intensity of 45 mm on a visual analogue scale. The statement emphasizes the need for universal and specific consideration of dyspnoea, as it is often dissociated from clinical, radiological, or physiological abnormalities. It highlights the challenges in identifying and managing dyspnoea, particularly in mechanically ventilated patients who may have barriers to signaling their distress. The statement provides an operational definition of dyspnoea and discusses its pathophysiology, prevalence, and impact on patients. It also outlines methods for detecting dyspnoea, including self-reporting and observation scales, and suggests strategies for relief, such as reassurance and enhancing patients' sense of control. The statement aims to address the underestimation of dyspnoea and its consequences, including anxiety, poor sleep, weaning failure, and increased risk of post-traumatic stress disorder (PTSD).