Acute respiratory distress syndrome (ARDS) is an acute hypoxic respiratory failure due to non-cardiogenic pulmonary edema with diverse etiologies and high mortality. This study has been conducted to assess etiologies, physiological variables, mortality and its predictors in the ICU.A prospective cross-sectional study was carried out with all the patients more than 14 years of age admitted to ICU of a general hospital that fulfilled the criteria of American-European Consensus Conference criteria for ARDS were included in the study.Out of total 42 patients, main etiologies were sepsis (30.7%), polytrauma (25%), fat embolism syndrome (25%), acute severe pancreatitis (5.7%) pneumonia (5.7%) and others (8.3%). Non-survivors had significantly lower pH, PaO2/FiO2 on day 3 and higher SOFA score. Hospital mortality was 38.9%. The causes of death were MOF (57.1%), septic shock (21.4%) and refractory hypoxaemia (21.4%). Factors significantly associated with mortality were PaO2/FiO2 on day 3, pH and SOFA score; and SOFA score of 13 or above was predictive of death.MOF was the most common cause of death. Sepsis was the most common etiology. ARDS was associated with high but comparable mortality. The non-survivors had significantly lower oxygenation, pH, and higher SOFA scores.