OBJECTIVE To formulate Expert Consensus on Clinical Application of Inhaled Aminoglycoside Antimicrobials in Lower Respiratory Tract Infections （hereinafter referred to as the “consensus”） in response to the lack of standardized clinical guidelines for the use of inhaled aminoglycoside antimicrobials in the treatment of lower respiratory tract infections， so as to improve the standardization and safety of their clinical application. METHODS Led by Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine， 35 experts in the fields of clinical pharmacy， critical care medicine， respiratory and critical care medicine， and pediatrics in China were convened. Nine clinical practice issues concerning inhaled aminoglycoside antimicrobials were systematically reviewed with domestic and international research evidence and clinical experience. After an in-depth discussion， the consensus was developed. RESULTS The consensus contained 21 recommendations covering nine aspects： therapeutic indications and regimens of inhaled aminoglycosides in different lower respiratory tract infectious diseases （such as bronchiectasis， cystic fibrosis， chronic obstructive pulmonary disease， etc.）， eligible populations and conditions for prophylactic use， principles of empirical use in the absence of definite etiology， strategies for combination therapy versus monotherapy， medication recommendations for special populations （children， patients with renal insufficiency， pregnancy and lactation， etc.）， monitoring and management of adverse reactions， establishment of a physician-pharmacist collaborative management model， selection and standardized use of inhalation devices， and key points of whole-process management and pharmaceutical care. CONCLUSIONS This consensus provides systematic evidence-based guidance for the clinical application of inhaled aminoglycoside antimicrobials in lower respiratory tract infections. It helps standardize clinical practice， optimize dosing regimens， ensure medication safety， and promote the implementation of a multidisciplinary collaborative management model， thereby improving patient outcomes.