Objective To explore in depth the experience of patients with acute respiratory distress syndrome (ARDS) undergoing awake prone position ventilation treatment. Methods A descriptive qualitative research was utilized, and 17 ARDS patients from April to June 2023 were selected to conduct semi-structured interviews. The data were analyzed using content analysis. Results Through the summarization and analysis of qualitative data, four themes were identified, including treatment motivation and expectations, patient experiences and feelings, factors facilitating prone positioning compliance, and barriers to prone positioning compliance. Conclusion The experience of patients undergoing awake prone positioning ventilation is influenced by a series of factors. For patients requiring awake prone positioning ventilation, improving patient comfort, enhancing treatment motivation and expectations, mobilizing family and social support systems, and supporting patient self-management efforts will help improve their compliance.