【Abstract 】 In recent 20 years, noninvasive positive pressure ventilation (NIPPV/NIV) was widely used in clinical practice. The use of NIV has been more and more sophisticated, then, more and more experience has been accumulated by physicians. However, many problems and confusions are also met and fund in clinical practice, particularly the rational application of NIV in severe pneumonia and acute respiratory distress syndrome (ARDS)induced acute hypoxemic respiratory failure (AHRF). Then, this review is to comment the recent progress on this subject.