Objective To explore the effects of mechanical ventilation in prone position with abdominal suspension on pulmonary compliance, oxygenation function and prone position-related adverse events in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).Methods A total of 68 patients with moderate-to-severe ARDS were randomly divided into 34 cases each in the control group and the experimental group.The control group was ventilated in the conventional prone position, and the experimental group was ventilated in the prone position with abdominal suspension assisted by gel position pads.The pulmonary comp-liance, oxygenation indexe and the incidence of prone position-related adverse events were compared between the two groups before prone position ventilation, at 4, 8, and 12 h of the ventilation, and at 4 h of post-ventilation.Results Tidal volume, plateau pressure, pulmonary compliance, PaO2, PaCO2, SpO2, and oxygenation index of the experimental group were significantly better than those of the control group in the different time points (all P＜0.05); the ocular complications in the experimental group was significantly lower than that of the control group (P＜0.05).Conclusion Mechanical ventilation in the prone position with abdominal suspension is conducive to improving pulmonary compliance and oxygenation function in patients with moderate-to-severe ARDS.