Objective To determine the curative effect of non-invasive positive pressure ventilation (NIPPV) in the treatment of the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type Ⅱ respiratory failure. Methods Forty-seven AECOPD patients complicated with type Ⅱ respiratory failure who admitted in our department from January 2012 to December 2014 were recruited in this study. They were randomly divided into the observation group (n＝24) and the NIPPV group (n＝23). All patients were given conventional treatment, including antibiotics, expectorant, anti-asthma and persistent low flow oxygen therapies. The NIPPV group was additionally treated with NIPPV. The blood gas analysis results, heart rate, breathing rate and serum level of N-terminal pro-brain natriuretic peptide (NT-proBNP) were compared between the 2 groups before and at 24 and 72 hours after the treatment. Results Compared with the values before treatment, the heart rate, breathing rate, arterial partial pressure of carbon dioxide (PaCO2), and serum level of lactic acid (Lac) were decreased significantly (P＜0.05), while, PaO2 and pH value were elevated significantly at 24 and 72 hours after treatment in both groups (P＜0.05), with those of the latter time point more significantly (P＜0.05). The serum level of NT-proBNP was also reduced in the 2 groups at 72 hours after treatment (P＜0.05). Compared with the observation group, the NIPPV group had more marked improvements in the heart rate, breathing rate, pH value, PaO2 ad serum levels of Lac and NT-proBNP (P＜0.05). What’s more, this group also had significantly shorter hospital stay and reduced costs than the other one (P＜0.05). Conclusion NIPPV has remarkable curative effect in the treatment of AECOPD patients complicated with type Ⅱ respiratory failure, and it is worthy of being widely applied in clinical practice.