The number of people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is increasing dramatically throughout the world [1], and in Italy [2, 3], particularly in the northern region of Lombardy [4]. Regional Italian medical and political authorities have implemented extraordinary measures to contain the spread of the virus. This disease may cause massive diffuse alveolar damage resulting in acute respiratory failure (ARF) that requires, in a high percentage of cases, mechanical ventilation [5–8]. Based on our general experience so far in dealing with the disease and on the existing knowledge (albeit still limited and evolving) [5–8], Italian respiratory scientific societies proposes here an Early Consensus Statement Management for non-ICU ARF SARS-CoV-2 emergency. It represents the expert opinion of pulmonologists directly involved in the first line of assistance. The Consensus identified two urgent areas for action: a) management, and b) organisation. We carried out a search of the published literature in PubMed, Ovid, Embase databases and relevant websites from the construction of the databases to March 20, 2020 in order to retrieve guidelines and recommendations, meta-analyses, systematic reviews, state of the art papers, and randomised trials. The search terms used were: “Coronavirus pneumonia”, “ARDS”, “Acute Hypoxemic Respiratory Failure”, “SARS”, “MERS”, “Influenza”, Acute Respiratory Failure or Mechanical Ventilation”, “Noninvasive ventilation AND Acute hypoxemic respiratory failure”. Based on the literature search, a small group of 4 pulmonologists professionals produced a preliminary document, which was then submitted to the consensus group of 10 doctors. Consensus on the final document was achieved through video conference meetings (Conference Call). Using a Delphi-like procedure, we asked the experts to rate the entire document on a 5-point Likert scale (0=totally disagree; 1=disagree; 2=sufficiently agree; 3=moderately agree; 4=totally agree). Consensus was considered when more than 75% of the respondents rated the document as “totally agree”. In this context the proposed paper is a changeable consensus not necessarily totally in line with the WHO documents because the Italian situation was and unfortunately still is continuously in progression day by day. Below we summarise the recommendations that we consider most appropriate and urgent.