In a series of three papers [1-3] and a Personal View [4] published by the The Lancet and Lancet Respiratory Medicine, researchers have summarised the current state of our knowledge of acute respiratory distress syndrome (ARDS) in children and adults, and outlined their visions for the future of the field. Common to these papers are the following suggestions: (1) although the criteria used to define ARDS have evolved over time, they need to evolve still further; (2) heterogeneity of the patient populations enrolled in ARDS clinical trials should be reduced by defining sub-groups (eg, according to treatable traits), thereby unlocking the door to precision medicine; and (3) improvements are needed in the diversity of the participants enrolled into ARDS research studies.