Acute lung injury (ALI)is a common clinical disease that causes serious health problems worldwide, but the pathogenesis is still not clear. Autophagy is one of the current hot spots in biomedical research and involves a variety of pathophysiological processes. Recent studies have shown that autophagy is associated with the development of multiple lung diseases including ALI. Exosomes are nanoscale structures (30~100 nm)secreted by a variety of living cells and surrounded by lipid bilayer membranes. It regulates cellcell communication and interactions by delivering proteins, lipids, and nucleic acids contained within its vesicles. The presence of exosomes has important physiological and pathological implications for their donor cells, recipient cells, and intercellular structures. Therefore, exploring the functions and characteristics of exosomes have received more and more attentions and become approaches for the diagnosis and treatment of diseases, new targets for strategic development. In this review, we summarize the pathophysiological effects of autophagy and exosomes in ALI in recent years and suggest possible associations between the two.