Acute respiratory distress syndrome (ARDS) investigations have more recently focused on long-term outcomes in survivors. Many survivors of ARDS have significant brain-related morbidity, including neurocognitive deficits and psychiatric disorders. Neurocognitive and psychiatric sequelae seem to improve during the first 12 months but may persist for years. Over the last decade, ARDS-related neurocognitive and psychiatric morbidity has been identified as a significant problem for patients and their families and is the subject of investigation by many ARDS investigators. Future research should focus on early identification of patients with neurocognitive and psychiatric morbidities, mechanisms of brain injury, and therapeutic modalities designed to prevent or decrease such morbidities. Until then, clinicians and patients should be made aware of the deleterious long-term effects of the intensive care unit stay.