BACKGROUND--Studies suggest that the mortality in adults with acute respiratory distress (ARDS) has not changed over the past two decades, despite the introduction of new therapeutic techniques and sophisticated ventilatory support devices. Mortality and physiological variables that might predict outcome in patients with ARDS were therefore assessed. METHODS--A retrospective survey was undertaken in 41 patients with ARDS. RESULTS--Mortality was 66%. Only the presence of sepsis predicted death. CONCLUSION--Mortality from ARDS is unchanged. Currently available severity scoring systems are not helpful in predicting outcome.