Objective To investigate the role of Ang⁃2 and sRAGE in the pathogenicity of sepsis related ARDS，and to evaluate whether Ang⁃2 and sRAGE can play an role in theearly diagnosis of sepsis related ARDS. Method Patients with sepsis related ARDS were enrolled as the experimental group in Shanxi Bethune Hospital from May 2021 to January 2022，patients with sepsis as the case control group，and healthy adults who underwent physical examination at the physical examination center during the same period were enrolled as the healthy control group. Patients in the experimental group were followed up for 28 days，and were divided into the survival group （n = 9）and the death group（n = 8）. The expression level of Ang⁃2 and sRAGE and the number or rate of labora⁃ tory indicators（WBC，NEUT，LY，NLR，MONO and EO）in each group were compared，and the risk factors of sepsis related ARDS and the diagnostic power of Ang⁃2 and sRAGE in the early recognition of sepsis related ARDS were analyzed. Results There were statistically significant differences in the expression level of Ang ⁃ 2 and sRAGE among the three groups （P < 0.01，P < 0.05 respectively）. Moreover，compared with the case control group （3 378.06/912.67，1 343.63/334.49）and the healthy control group（2 852.48/411.97，1 365.53/211.54），the expres⁃sion level of Ang⁃2 and sRAGE in experimental groups（4 031.28/815.26，1 514.86/344.44）is notablely increased （P < 0.05）. Multivariate Logistic regression analysis showed that Ang⁃2 and sRAGE were the risk factors for sepsis related ARDS（P < 0.05，P < 0.01respectively）. ROC curve was plotted and it was found that the high level of Ang⁃2 and sRAGE had certain diagnostic value in the early identification of sepsis related ARDS. However，the diagnostic power of sRAGE（AUC 0.702，sensitivity 76.5%，specificity 45.5%）was inferior to that of Ang⁃2（AUC 0.724， sensitivity 94.1%，Specificity 48.3%），and the latter was evidently associated with a higher deathrisk at 28 days in the experimental group（P < 0.05）. Conclusion The expression level of Ang⁃2 and sRAGE is markedly increased in patients with sepsis related ARDS，and the high level of Ang⁃2 and sRAGE is a risk factor for sepsis related ARDS. Both the high level of Ang⁃2 and sRAGE have certain diagnostic power in the early identification of sepsis related ARDS，but the diagnostic power of sRAGE is less thanthat of Ang⁃2，and the latter is remarkably associat⁃ ed with a highdeathrisk of at 28 days in the experimental group.