Sepsis is one of the main cause of patients' death. Lung is the most vulnerable target organ during sepsis, and sepsis patients are often complicated with acute respiratory distress syndrome (ARDS), of which the main mechanism is vascular leakage caused by cytoskeleton rearrangement and cell-to-cell connection changes. IQ-guanosine triphosphatease-activating protein 1 (IQGAP1) has become the key component of cytoskeleton dynamics regulation in recent years. At present, the relationship between IQGAP1 and ARDS induced by sepsis is not yet clear. In this article, we will review the mechanism of the interaction between IQGAP1 and pathogenic microorganisms, changes of pulmonary micro vascular barrier function and cyto-skeleton at the molecular level.