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The role and methods of oxygen therapy in acute hypoxemic respiratory failure (AHRF) need to be clarified, justifying the organization of a consensus conference by the French Intensive Care Society (Société de réanimation de langue française; SRLF) and the French Emergency Medicine Society (Société française de médecine d’urgence; SFMU). The conference excluded acute pulmonary edema and acute hypercapnic exacerbation of chronic obstructive pulmonary disease from its scope. The jury confirmed the indication for oxygen therapy in the presence of AHRF, with a target oxygen saturation (SpO2) between 94% and 98% in the absence of risk factors for oxygen-induced hypercapnia, and between 88% and 92% when such factors are present. Arterial blood gases should not be taken routinely, and venous blood gas analysis is recommended to exclude hypercapnia. Arterial blood gas analysis should be performed when SpO2 is unreliable, when partial pressure of carbon dioxide (PvCO2) is elevated, in the presence of hemoglobinopathy, suspected methaemoglobin or nitric oxide intoxication, or when there is a co-existing non-respiratory indication. Criteria for high-flow nasal oxygen therapy (HFNO) and intubation have been clarified. HFNO is preferred to non-invasive ventilation (NIV) for de novo AHRF. Conscious prone positioning is proposed for patients with COVID-19 pneumonia requiring HFNO. Physiotherapy is recommended to improve alveolar recruitment in stable patients requiring admission to the Intensive Care Unit (ICU). Patients receiving conventional oxygen therapy who show signs of distress, or those receiving oxygen therapy with continuous positive airway pressure (CPAP), HFNO, or NIV should be managed in an ICU.