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Introduction: Chest physiotherapy (CPT) is commonly used in acutely ill patients, although evidence for its effectiveness is limited and controversial. Electrical Impedance Tomography (EIT) is a recent technique that can offer new information on lung function during ventilation. Hypothesis: This study used EIT (Dr?r Pulmovista 500) to evaluate the effects of CPT in spontaneously breathing hypoxemic patients hospitalized in our Dept of Intensive Care. Methods: We enrolled 51 adult patients in February and March 2012 who required CPT based on clinical status, gas exchange and chest X-ray findings. Patients were evaluated before, immediately after and one hour after a 15 min session of CPT in a semi-recumbent position. Treatments (including FiO2) were not changed during the study period. We studied the evolution in SpO2, variations in regional distribution of ventilation (TV) and changes in end-expiratory lung impedance (?EELI). Secondary outcomes included changes in hemodynamic status and respiratory rate. Results: CPT resulted in significant increases in SpO2 (p < 0.02) and?EELI also increased by 48% (p<0.001) immediately after CPT. There was a positive correlation between?SpO2 (maximal SpO2 reached during CPT – SpO2 before CPT) and?EELI in the dorsal region (r= 0.322, p=0.021). There was also a positive relationship between the PaO2/FiO2 (P/F) ratio at baseline and the?EELI in the dorsal region: patients with a lower P/F ratio had a lower or a negative?EELI. After CPT there was a significant decrease in the dorsal regional distribution of ventilation (p=0.043), together with a trend towards an increase in the ventral regional distribution of ventilation over time (p=0.053). Hemodynamic variables and respiratory rate remained stable over time. Conclusions: These results provide evidence of effectiveness of a 15 min session of CPT in improving gas exchange and lung recruitment (positive?EELI) in spontaneously breathing hypoxemic patients. Improvement in gas exchange was sustained one hour after CPT.