The article presents modern data on pathomorphological changesin lung tissue formed under the influence of acute and chronic intoxication with ethanol and its metabolites. At autopsy of the persons abusing alcohol, along with defeat ofabrain, heart, a liver note considerable changes in lungs. It was found that ethanol is excreted by the lungs and kidneys unchanged. The lungs are actively involved in the conversion of ethanol into carbon dioxide. The toxic effect ofethanol and its metabolites increases the permeability of the vascular wall, which leads to the accumulation of protein in the lung tissue with the development of pronounced dystrophic and destructive changes with the formation ofsubsequent pneumosclerosis. Alcohol negatively affects the function of alveolar macrophages, which have an important role inprotecting the lungs. Under the influence of ethanol in macrophages, biochemical processes are slowed down, expressed in a sharp decrease in their phagocytic activity and ability to move. In turn, it is necessary to note the studies that reflect the data on the influence of alcohol on the lung surfactant, which stabilizes the surface tension in the alveoli and counteracts the transudation of fluid into the alveoli. Alcohol adversely affects the phospholipids included in the surfactant and disrupts the process of its formation. Alcohol intoxication is the cause of 60% of comatose States, and obturation-aspiration complications are the leading form of respiratory disorders. Alcohol-induced disorders of the mucociliary apparatus contribute to the ingress of foreign particles into the respiratory tract. The defeat of these protective mechanisms in combination with a decrease in the overall immune reactivity of the body cause the development of anumber of pathological changes in the lungs. Thus, the study of morphological features of lung injuries in acute ethanol poisoning is of fundamental importance in elucidating the links of pathogenesis ofterminal States, their justified therapy.