Background: Inflammation, noncardiogenic pulmonary edema, and injury to the alveolar epithelium and the endothelial barrier of the pulmonary arteries lead to sudden respiratory failure in a clinical entity known as respiratory distress syndrome (ARDS). Finding out how well PH evaluated by transthoracic echocardiography predicts 30-day in intensive care unit (ICU) patients with respiratory distress syndrome was the primary goal of study. Methods: Hundred individuals diagnosed with respiratory distress syndrome were included in observational research. Group I consisted of patients with ARDS and PH, group II consisted of patients with normal PASP. Each group received an equal number of patients. Results: (r = 0.801, P < 0.001) and LVEF (r = 0.767, P <0.001) were positively correlated with PaO2/FiO2 in a substantial way. The results showed clear negative relationships with TR maximal PG (r = -0.848, P < 0.001), RAP (r = -0.625, P < 0.001), and PASP (r = -0.986, P < 0.001). For the purpose of predicting in ARDS patients with PHT, ROC analysis was performed for . A significant under the curve (AUC) of 0.917 was shown, with a 95% confidence range ranging from 0.843 to 0.991 (P < 0.001). With a sensitivity of 74.3% and a specificity of 100%, respectively, the optimal cutoff was < 1.5. Conclusions: A major predictor of 30-day in patients admitted to the ICU with ARDS is echocardiographic measurement of pulmonary hypertension (PH).