This review discusses the development, current status, and future prospects of inhalable nano-formulations for pulmonary drug delivery. Inhalable nano-formulations offer advantages such as improved drug solubility, enhanced bioavailability, targeted delivery, and better lung deposition. However, industrialization of these formulations remains limited, with only one FDA-approved product, ARIKAYCE, available for treating lung diseases. The review highlights the challenges in translating inhalable nano-formulations into clinical practice, including the need for suitable inhalation devices that can effectively deliver these formulations. It categorizes various inhalation devices, such as MDIs, DPIs, and nebulizers, and evaluates their suitability for nano-formulations. The study emphasizes the importance of device formulation adaptability and the need for further research to optimize delivery mechanisms. Among the devices, vibrating mesh nebulizers are identified as the most suitable for delivering inhalable nano-formulations due to their efficiency, low particle residue, and ability to maintain drug stability. The review also presents a case study of ARIKAYCE, which uses a vibrating mesh nebulizer and has shown promising results in treating MAC lung disease. Overall, the review concludes that while inhalable nano-formulations hold great potential, significant challenges remain in their industrialization and clinical application.This review discusses the development, current status, and future prospects of inhalable nano-formulations for pulmonary drug delivery. Inhalable nano-formulations offer advantages such as improved drug solubility, enhanced bioavailability, targeted delivery, and better lung deposition. However, industrialization of these formulations remains limited, with only one FDA-approved product, ARIKAYCE, available for treating lung diseases. The review highlights the challenges in translating inhalable nano-formulations into clinical practice, including the need for suitable inhalation devices that can effectively deliver these formulations. It categorizes various inhalation devices, such as MDIs, DPIs, and nebulizers, and evaluates their suitability for nano-formulations. The study emphasizes the importance of device formulation adaptability and the need for further research to optimize delivery mechanisms. Among the devices, vibrating mesh nebulizers are identified as the most suitable for delivering inhalable nano-formulations due to their efficiency, low particle residue, and ability to maintain drug stability. The review also presents a case study of ARIKAYCE, which uses a vibrating mesh nebulizer and has shown promising results in treating MAC lung disease. Overall, the review concludes that while inhalable nano-formulations hold great potential, significant challenges remain in their industrialization and clinical application.