Background <p>Aquaporins (AQPs) are a class of channel proteins expressed on the cell membrane, responsible for facilitating the transport of water molecules and certain small solutes across the membrane. Their dysregulation is involved in the occurrence and progression of major lung diseases.</p> Findings <p>We systematically reviewed the expression and functional alterations of AQPs in acute lung injury (ALI), pneumonia, asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF) and lung cancer, and integrated the potential molecular mechanisms. In addition, we examine the regulatory mechanisms of traditional Chinese medicine on lung AQPs, and summarizes the research progress of inhibitors and small molecular compounds that modulate AQPs in lung diseases.</p> Implications <p>AQPs may serve as promising therapeutic targets for lung diseases. This review offers novel insights and a foundation for the diagnosis, treatment, and drug development of lung diseases, positioning AQPs as a potential tool in combating these conditions.</p> Graphical abstract <p></p>