Objective To investigate the value of vibration response imaging (VRI) in the assessment and monitoring of therapeutic efficiency of chronic obstructive pulmonary disease (COPD) in the elderly patients. Methods A total of 41 patients (over 60 years old) with acute exacerbations of COPD hospitalized in our department from January to June 2012 were recruited in this study. Dyspnea score, arterial blood gases analysis, lung function test and VRI were performed on them before and after treatment. Results Dyspnea grade was significantly reduced after treatment [(3.46±0.87) vs (2.17±0.80), P＜0.01]. PaO2, lung function and VRI results were improved significantly after treatment. Dynamic image grades were reduced from (3.61±1.09) to (2.85±1.26) (P＜0.01), graph grades from (10.54±2.91) to (6.15±2.23) (P＜0.01), and crack counts from (9.98±7.51) to (3.15±4.44) (P＜0.01). Conclusion VRI is helpful in the assessment and monitoring of therapeutic efficiency of COPD in elderly patients.