Surfactant protein D has multiple functions in innate immunity in the lung. The generation of SP-D knock-out mice has revealed a central role for this protein in the control of lung inflammation. Accumulating evidence in mouse models of infection and inflammation indicates that truncated recombinant forms of surfactant protein D are biologically active in vivo. This review addresses the structural requirements for recognised activities of SP-D in vitro and in vivo, with emphasis on evidence arising from studies with transgenic mice and mouse models of inflammatory lung disease. The potential of truncated recombinant forms of surfactant protein D as novel therapy for infectious and inflammatory disease is discussed.