Introduction: Acute respiratory distress syndrome is a disease with severe, progressive and irreversible hypoxemia, of multicausal origin, rare in pediatric intensive units but with high mortality due to multiple organ failure caused by prolonged oxygen deficiency. Results: 282 patients were recorded in the period, 63.7% under the age of six, 54.4% of the male sex and 51.1% of white skin. Clinical forms of lung prevailed (58.1%) and correlate (p-0.022) with survival, the median duration of mechanical ventilation was 10 days. There is a ratio (p-0.000) between ventilation duration and mortality. An overall mortality of 40.78% (n-115) was reported. Conclusions: The acute respiratory distress syndrome has a higher incidence in those under the age of six, in clinical forms of the lungs, which are associated with greater survival, which rises as they increase days of mechanical ventilation. Materials and Methods: Retrospective study of patients admitted to 15 pediatric intensive care units in 13 provinces of Cuba, which were diagnosed with acute respiratory distress, according to the Rome consensus, in the period from January 2016 to December 2018. The data were obtained from each patient's clinical records. Demographic variables, clinical forms of acute respiratory distress syndrome, duration of mechanical ventilation and mortality were evaluated. Qualitative variables are shown in frequency tables by numbers and per cents, in the quantitative variables the classic analysis associated with contingency tab, such as Pearson's ji-square and comparison of stockings. Acute respiratory distress syndrome is a heterogeneous etiology and pathophysiology entity that is severe, progressive and irreversible hypoxemia [1]. For your diagnosis are combined clinical, hemodynamic and oxygenation criteria who were endorsed in Ecc [2] used for many years to identify and treat ARDS in both adult and pediatric patients.