Acute lung injury (ALI) is an acute hypoxic whistling insufficiency caused by damage to alveolar epithelial cells and capillary endothelial cells resulting in diffuse interstitial lung and alveolar edema due to various direct and indirect injury-causing factors. It is characterized by reduced lung volume, reduced pulmonary compliance, and imbalance of ventilation/blood flow ratio, and is clinically characterized by progressive hypoxemia and whistling distress, with non-homogeneous exudative lesions on lung imaging. Its prevalence and mortality rates remain high. The use of mechanical ventilation after admission to the intensive care unit generates high medical costs and late effects on lung function, both of which seriously threaten the quality of survival and prognosis of patients. In contrast, studies have found that aspirin has a role in the treatment of acute lung injury. Aspirin and thromboxane A2: Thromboxane A2 is a pro-inflammatory factor with an important regulatory role in acute lung injury, and inhibition of thromboxane A2 expression has a protective effect on acute lung injury. Aspirin was found to have the function of inhibiting platelet production of thromboxane A2. In a mouse model of transfusion-associated acute lung injury induced by 2 hits of LPS and MHC I mAb, Looney et al. found that aspirin pretreated mouse lung tissues showed reduced platelet aggregation, decreased degree of lung injury, improved oxygenation, and significantly lower morbidity and mortality, probably through the inhibition of cyclooxygenase activity Reduced plasma levels of thromboxane A2. Aspirin and P-selectin: In acute lung injury, plasma levels of soluble P-selectin are significantly upregulated, which has the effect of promoting mutual adhesion of platelets with capillary endothelial cells in the lung, as well as platelet self-activation. In the LPS-induced acute lung injury model, the expression of P-selectin in the lung tissue was significantly reduced in the aspirin pretreatment group, and the histopathological changes in the lung were reduced, and the aggregation of neutrophils and platelets in the lung was significantly reduced. Aspirin and 15-differential isomer-lipoxygenin A4: 15-differential isomer-lipoxygenin A4 has anti-inflammatory effects mainly by inhibiting the expression of inflammatory factors and chemokines, inhibiting neutrophil activation and its transvascular endothelial cell movement, promoting neutrophil apoptosis, as well as enhancing phagocytosis of apoptotic neutrophils by alveolar macrophages, inhibiting increased permeability of vascular endothelial cells and pro-inflammatory factors IL-6 expression, etc. Aspirin promotes an increase in the anti-inflammatory lipid molecule 15-differential isomer-lipoxygenin A4 via acetylation at the Ser530 site, which plays an important role in the prevention of acute lung injury. Sakamaki et al. found significantly reduced intrapulmonary platelet aggregation, degree of lung injury, and higher mouse survival in the aspirin-treated group in a mouse model of transfusion-associated acute lung injury induced by 2 hits of LPS and MHC I mAb. It is suggested that prophylactic administration of appropriate aspirin to high-risk patients may improve early oxygenation and deficiency in acute lung injury. In an international multicenter prospective cohort study including 20 hospitals in the United States and 2 hospitals in Turkey included 3,855 high-risk patients in 22 hospitals for 6 months; 25.3% of these high-risk patients took aspirin prehospital for antiplatelet therapy, and only 6.2% of this population were eventually diagnosed with acute lung injury. a clinical investigated whether the use of the antiplatelet therapy drug aspirin in critically ill patients affected the occurrence, development, and prognosis of acute lung injury. The study included 161 patients, 49.0% of whom were on aspirin antiplatelet therapy (single loading dose of 325 mg on day 1 of admission, followed by 81 mg orally daily for 2 to 7 d until discharge or death), and only 7.6% of critically ill patients receiving aspirin antiplatelet therapy developed acute lung injury; clarifying the role of the antiplatelet therapy drug aspirin in The positive role of antiplatelet therapy aspirin in the treatment of acute lung injury. In conclusion, the treatment of acute lung injury is limited and expensive, and the early prognosis and late lung function and quality of survival are not satisfactory. However, preclinical and clinical trials have shown that aspirin has a good preventive and therapeutic effect on the occurrence of acute lung injury, providing us with new ideas in the treatment of acute lung injury.