Acute Respiratory Distress Syndrome (ARDS) is a significant global health issue with high in-hospital mortality. Its impact extends beyond the acute phase, leading to long-term mortality and disability. Post-Intensive Care Syndrome (PICS) is a key concern, characterized by persistent physical, cognitive, and mental impairments. ARDS survivors often experience ICU-acquired weakness, which affects mobility and daily activities. Risk factors include prolonged bed rest, sedatives, and neuromuscular blocking agents (NMBA). Corticosteroids, used in ARDS management, may contribute to muscle weakness and cognitive impairment. The optimal use of corticosteroids remains uncertain. Mental health challenges, such as depression and post-traumatic stress disorder, are also common in ARDS survivors. Effective strategies include the ABCDEF bundle, emphasizing early mobilization, delirium monitoring, and family involvement. Long-term outcomes are influenced by both the severity of ARDS and complications from treatment. Improving acute care can significantly impact long-term recovery. Future efforts should focus on comprehensive survivorship care, involving multidisciplinary teams and addressing both acute and long-term needs. ARDS survivorship care should begin early in the ICU stay. Long-term follow-up is essential to assess and manage PICS. Global efforts are needed to ensure equitable care and long-term outcomes for ARDS survivors.Acute Respiratory Distress Syndrome (ARDS) is a significant global health issue with high in-hospital mortality. Its impact extends beyond the acute phase, leading to long-term mortality and disability. Post-Intensive Care Syndrome (PICS) is a key concern, characterized by persistent physical, cognitive, and mental impairments. ARDS survivors often experience ICU-acquired weakness, which affects mobility and daily activities. Risk factors include prolonged bed rest, sedatives, and neuromuscular blocking agents (NMBA). Corticosteroids, used in ARDS management, may contribute to muscle weakness and cognitive impairment. The optimal use of corticosteroids remains uncertain. Mental health challenges, such as depression and post-traumatic stress disorder, are also common in ARDS survivors. Effective strategies include the ABCDEF bundle, emphasizing early mobilization, delirium monitoring, and family involvement. Long-term outcomes are influenced by both the severity of ARDS and complications from treatment. Improving acute care can significantly impact long-term recovery. Future efforts should focus on comprehensive survivorship care, involving multidisciplinary teams and addressing both acute and long-term needs. ARDS survivorship care should begin early in the ICU stay. Long-term follow-up is essential to assess and manage PICS. Global efforts are needed to ensure equitable care and long-term outcomes for ARDS survivors.