The purpose of this work is an in-depth study of main morphological features and pathogenesis of acute lung injury in cases of acute fatal poisoning with ethanol; assessment of microcirculation disorders in the respiratory system; details of the mechanisms of devel-opment of non-cardiogenic pulmonary edema. An analysis of 160 deaths of men and women aged 19 to 85 years from acute ethanol poisoning was made. Histological preparations were colored with hematoxylin and eosin according to the Van Gieson method, elas-tic fibers — according to Weigert. It was established that the first reaction in response to the effect of ethanol is hemodynamic disor-ders, then interstitial and alveolar edema develops; pronounced changes occur in endothelial cells, which lead to plasmorrhagia and hyalinosis.