Hemorrhagic shock is hypovolemic shock caused by various blood loss which results in tissue and organ hypoperfusion. Accompanied by coagulation dysfunction, hypothermia, acidosis, inflammatory response and hemorrhagic shock can lead to multiple organ dysfunction syndrome and even be life-threatening. Lung is usually the most vulnerable organ and the first organ showing symptoms during hemorrhagic shock. Acute respiratory distress syndrome (ARDS) has a mortality rate around 40% following acute lung injury (ALI). Hemorrhagic shock-induced ALI/ARDS involves a series of pathophysiological processes, such as insufficient blood perfusion, cell damage, recruitment and infiltration of inflammatory cells and cytokine releasing. However, the underlying mechanisms are not yet completely clear. Based on the pulmonary endothelial and epithelial injury, inflammatory cell recruitment, and inflammatory response, the authors mainly review the recent advances in mechanisms of hemorrhagic shock-induced ALI/ARDS to provide references for clinical treatment and researches.