Background <p>Sepsis-induced acute lung injury (ALI) is characterized by edema resulting from increased vascular permeability. Transient receptor potential vanilloid 4 (TRPV4) interacts with inositol 1,4,5-trisphosphate receptor type 1 (IP3R-1) through calmodulin-binding domains and regulates vascular permeability. However, the specific mechanisms underlying the roles of TRPV4 and IP3R-1 in endothelial pyroptosis and vascular permeability remain unclear.</p> Methods <p>EMPs were measured in septic patients and controls, and co-cultured with human pulmonary microvascular endothelial cells (HPMECs). LPS-induced ALI was assessed in wild-type or <i>Gsdmd</i>^{<i>−/−</i>} mice with pharmacological modulation of TRPV4, as well as in <i>Trpv4</i>^{<i>−/−</i>} mice. Pyroptosis was detected in <i>IP3R-1</i>-silenced HPMECs treated with LPS and TRPV4 agonist. IP3R-1/GSDMD interaction was confirmed by structural prediction, Co-IP, and immunofluorescence. Intracellular Ca²⁺ was detected by flow cytometry, and tissue Ca²⁺ was visualized by in vivo imaging.</p> Results <p>Elevated EMPs in septic patients enhanced endothelial permeability, upregulated TRPV4 and GSDMD-NT generation in HPMECs. TRPV4 promotes HPMECs permeability and pyroptosis in an IP3R-1-dependent manner. TRPV4 inhibition attenuated lung injury and ameliorated pulmonary dysfunction, while <i>Trpv4</i> knockdown improved survival. Knockdown of <i>IP3R-1</i> reduced intracellular Ca²⁺ and mtDNA levels in HPMECs. In vivo imaging revealed attenuated Ca²⁺ accumulation in <i>Trpv4</i>^{<i>−/−</i>} mice. The interaction between TRPV4/IP3R-1 and GSDMD was Ca²⁺-dependent.</p> Conclusions <p>TRPV4 disrupts HPMEC integrity via IP3R-1 and triggers GSDMD-mediated pyroptosis through a Ca²⁺-dependent mechanism, exacerbating LPS-induced ALI.</p>