Inflammatory processes are a key event in various respiratory disorders. Adhesion to microvascular endothelial cells is essential for the migration of leukocytes into inflamed tissues. Intercellular adhesion molecule-1 (ICAM-1) is a member of the immunoglobulin superfamily and a ligand for lymphocyte function-associated antigen-1 alpha (LFA-1 alpha). It has been shown to be required for leukocyte migration into inflamed tissues, and to play a significant role in inflammatory diseases, including rhinovirus infections. Clinical and experimental investigations have demonstrated a close relationship between the ICAM-1/LFA-1 alpha pathway and the pathogenesis of asthmatic responses and acute respiratory distress syndrome. Further progress in research on the antagonism of ICAM-1 and LFA-1 alpha may provide new therapeutic approaches to inflammatory lung diseases.