Objective To discuss the value of pulmonary ventilation score in evaluating the extravascular lung water (EVLW) of patients with acute respiratory distress syndrome (ARDS). Methods We retrospectively collected the clinical data of 32 patients with ARDS, who were treated in the Department of Critical Care Medicine of Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from Jun. 2015 to Feb. 2017 and improved within 7 days. The total pulmonary ventilation score, extravascular lung water index (EVLWI), oxygenation index (PaO₂/FiO₂), and central venous pressure (CVP) of patients at admission and after treatment for 7 d were recorded. The correlations between total pulmonary ventilation score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, EVLWI, oxygenation index and CVP were analyzed. Results The APACHE Ⅱ score, total pulmonary ventilation score and EVLWI of the ARDS patients after treatment for 7 d were significantly decreased compared with those at admission, and the oxygenation index was significantly increased (all P<0.01). The pulmonary ventilation score was positively correlated with the APACHE Ⅱ score, EVLWI and CVP (r=0.95, 0.95, 0.64; all P<0.01), and was negatively correlated with the oxygenation index (r=-0.94, P<0.01). Conclusion Pulmonary ventilation score can effectively evaluate the EVLW of patients with ARDS, and can be used as an effective supplement for EVLW monitoring in patients with ARDS in addition to pulse indicator continous cadiac output.