Pyroptosis is a form of programmed cell death mediated by gasdermin family proteins, including GSDMA, GSDMB, GSDMC, GSDMD, GSDME, and DFNB59. It is characterized by inflammatory responses and membrane pore formation, leading to cell swelling and lysis. Pyroptosis plays a dual role in respiratory diseases, contributing to both disease progression and therapeutic outcomes. In lung cancer, pyroptosis can promote cancer cell death and enhance antitumor immunity, but it also causes adverse drug reactions. In pneumonia, pyroptosis can protect against pathogens but may lead to excessive inflammation and tissue damage. In asthma, pyroptosis is linked to disease susceptibility and severity. Pyroptosis is also involved in other respiratory diseases such as acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD). Therapeutic strategies targeting pyroptosis include chemotherapy drugs and natural products that inhibit pyroptosis to reduce toxicity and enhance treatment efficacy. However, the dual nature of pyroptosis presents challenges in clinical translation, requiring careful modulation to achieve therapeutic benefits. Understanding the molecular mechanisms of pyroptosis is crucial for developing targeted therapies and improving outcomes in respiratory diseases.Pyroptosis is a form of programmed cell death mediated by gasdermin family proteins, including GSDMA, GSDMB, GSDMC, GSDMD, GSDME, and DFNB59. It is characterized by inflammatory responses and membrane pore formation, leading to cell swelling and lysis. Pyroptosis plays a dual role in respiratory diseases, contributing to both disease progression and therapeutic outcomes. In lung cancer, pyroptosis can promote cancer cell death and enhance antitumor immunity, but it also causes adverse drug reactions. In pneumonia, pyroptosis can protect against pathogens but may lead to excessive inflammation and tissue damage. In asthma, pyroptosis is linked to disease susceptibility and severity. Pyroptosis is also involved in other respiratory diseases such as acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD). Therapeutic strategies targeting pyroptosis include chemotherapy drugs and natural products that inhibit pyroptosis to reduce toxicity and enhance treatment efficacy. However, the dual nature of pyroptosis presents challenges in clinical translation, requiring careful modulation to achieve therapeutic benefits. Understanding the molecular mechanisms of pyroptosis is crucial for developing targeted therapies and improving outcomes in respiratory diseases.