Abstract:Acute lung injury, a frequent complication in septic patients, is marked by complex pathogenesis and poor clinical outcomes.. Long non-coding RNA, recognized as a key regulator in sepsis development, has garnered significant attention. Thus, exploring potential long non-coding RNA gene targets holds great significance for further research on the treatment and prognosis of sepsis - induced acute lung injury. In this review, we clarify the mechanisms of long non - coding RNAs in treating acute lung injury by systematically reviewing their regulation of macrophages, including the mechanisms of action such as alveolar macrophage polarization, autophagy, and pyroptosis, as well as different signaling pathways such as the lncRNA/miRNA/MyD88/NF- κB axis and the LncRNA/p65/NF- κB axis, in order to offer references for exploring new clinical targets and treatments.