Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized as an increased pulmonary capillary permeability and systemic inflammation. More than 60% of ARDS patients complicated with hemodynamic disorder, which might be worsen during mechanical ventilation. It is important to assess volume status and correct hemodynamic disorder during treatment of ARDS. In addition to restrictive fluid management strategy, an individualized fluid management according to different stage and type of the disease, mechanical ventilaiton setting and synchrony, recruitment maneuver, use of sedatives and analgesics, fluid type we give to the patient, as well as avoiding acute cor pulmonale,is necessary to manage ARDS patients complicated with hemodynamic disorder. This review makes a summary of the advances in fluid management of ARDS patients.