Influenza is primarily a respiratory tract infection involving the exacerbation and inflammation of the respiratory tract, which can progress to life-threatening pneumonia, hypercytokinemia, edema, acute lung injury, respiratory failure and death. Viral mutations and drug resistance are the leading challenges in influenza prevention and treatment. Aerosol inhalation provides rapid availability and sustained therapeutic levels of antiviral drugs in the respiratory tract, without causing a systemic burden to unaffected tissues and organs. Furthermore, aerosol delivery enhances the bioavailability of antiviral drugs with poor oral adsorption. Nasal spray delivery of vaccines provides a safe and needle-free means of vaccination, and contains live-attenuated virus that induces mucosal immunity and provides long-lasting immunity relative to injectable inactivated vaccines. Since influenza is a disease with respiratory clinical manifestations, specific delivery of antiviral drugs or vaccines to the respiratory tract may represent a safe and effective approach to combat influenza.