Acute respiratory distress syndrome (ARDS) is a severe inflammatory reaction in the lungs caused by sudden pulmonary and systemic injuries. Clinically, this diverse syndrome is marked by sudden hypoxemic respiratory failure and the presence of bilateral lung infiltrates visible on a chest X-ray. ARDS management remains largely supportive, with a focus on optimizing mechanical ventilation strategies and addressing the underlying causes of lung injury. The current pharmacological approach for ARDS primarily focuses on corticosteroids, neuromuscular blocking agents, and beta-2 agonists, however, none has been definitively proven to be consistently effective in improving clinical outcomes. This review summarizes the latest evidence regarding the effectiveness and limitations of these pharmacological interventions, identifying key areas where further research is needed.