Direct drug delivery to the lungs is considered the gold standard for the treatment of a variety of respiratory diseases, owing to the increased therapeutic selectivity of the inhalative approach. Airborne formulations with defined size characteristics are required to improve the deposition pattern within the airways. In this respect, different nebulizer systems have been conceived, which has enabled the generation of respirable medicament mists. Here, vibrating-mesh technology revealed significant potential to overcome the main shortcomings associated with 'traditional' devices. Tailored orifice dimensions and defined formulation characteristics are of special interest for the generation of suitable aerosol droplets for inhalative purposes. Ongoing developments in device and formulation design will optimize the clinical outcome of inhalative drug delivery under application of vibrating-mesh technology.