Long-term follow-up of 9 survivors of the adult respiratory distress syndrome at 39 to 83 months demonstrated 2 patients with continued improvement of their restrictive pattern, 3 patients with stable mild obstructive disease, one patient who had had chronic obstructive pulmonary disease before the adult respiratory distress syndrome with continued pulmonary deterioration, and 4 patients without symptoms and with normal pulmonary function tests. Attention is drawn to bronchial reactivity as defined by a bronchodilator response of more than 60 per cent increase in maximal mid-expiratory flow, positive methacholine challenge, or development of bronchospasm after exercise in 3 patients having clinical symptoms of wheezing on recovery.