Objective To investigate the effect of bilirubin on acute lung injury (ALI) of oxidative/antioxidative parameters and ICAM-1 mRNA expression in pulmonary vascular endothelial cells. Methods Thirty male Wistar rats were randomly divided into three groups:control group, ALI model group and pre-treatment bilirubin group. Oxidative/antioxidative parameters and ICAM-1 mRNA expression were determined. Results In ALI model group,MDA content and ICAM-1 mRNA expression in pulmonary vascular endothelial cells were significantly higher than those in control group(P0.01 and P0.001), but the level of SOD and GSH-Px were significantly lower than those in control group (P0.01). In pre-treatment bilirubin group, MDA content and ICAM-1 mRNA expression were significantly lower than those in ALI model group(P0.01,P0.001),but the activities of SOD and the content of GSH-Px were significantly higher than those in ALI model group(P0.01,P0.05). Conclusion Bilirubin might significantly alleviate the degree of ALI by antioxidation and inhibit excess production of ICAM-1 mRNA.