Abstract: Objective To discuss the treatment effect of bi-level positive airway pressure ventilation (BiPAP) and naloxone for the treatment of chronic obstructive pulmonary disease (COPD) in acute exacerbation combined with type II respiratory failure. Methods 38 cases with COPD in acute exacerbation and type II respiratory failure from Jan. 2008 to Dec. 2010 were treated with BiPAP combined with naloxone on the basis of conventional treatment; 40 cases in control group were treated with oxygen inhalation, anti-infection and so on. PH, PaO2, PaCO2 and SaO2 before and after treatment in two groups were compared, and the change of HR, RR, MAP and clinical symptoms were observed. The hospitalization time, intubation rate and mortality rate were also observed. Results After treatment, PaCO2 was obviously decreased in two groups, PH was increased, PaO2 and SaO2 were obviously increased, the difference had statistical significance (P<0.05). HR, RR and blood pressure were obviously improved after treatment, the difference had statistical significance (P<0.05). The improvement of each index in observation group was obviously higher than that in control group after treatment, the difference had statistical significance (P<0.05). Compared with control group, observation group had shorter hospitalization time, lower intubation rate and mortality rate, the difference was obvious and had statistical significance (P<0.05). Conclusion The treatment of COPD in acute exacerbation combined with type II respiratory failure by BiPAP and naloxone has obvious curative effect. It can obviously decrease the intubation rate and mortality rate, which is worth of spreading in clinic.