【Abstract】 Objective To investigate the application of mechanical ventilation of oral tracheal intubation guided by fiberoptic bronchoscope in the rescue of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 43 AECOPD patients admitted to our hospital from December 2016 to November 2017 were selected as the control group. 43 AECOPD patients admitted between December 2017 and November 2018 were included in the study group. Patients in the study group were treated with fiberoptic bronchoscopy, orthotopically intubated, bronchoalveolar lavage, and non-invasive sequential mechanical ventilation. The control group was treated with laryngoscope with or without invasive sequential mechanical ventilation after orotracheal intubation and vacuum suction. The success rate of one-time intubation, average intubation time, pre-discharge complication rate, respiratory failure correction time after intubation, invasive ventilation time, and time of pulmonary infection control window (PIC) were compared between the two groups. The changes in vital signs before and after intubation were compared between the study group patients. Results The success rate of one-time intubation was significantly higher in the study group than in the control group (P<0.05). The mean intubation time and pre-discharge complication rate were significantly lower than those in the control group (P<0.05). The correction time, invasive ventilation time and PIC appearance time of patients in the study group were significantly lower than those of the control group (P<0.05). There were no significant differences in vital signs such as heart rate, systolic blood pressure, diastolic blood pressure, finger vein oxygen saturation, arterial blood PaO2 ， and arterial blood PaCO2 before and after intubation in the study group (P〉0.05). Conclusion The fiberoptic bronchoscope can effectively improve the success rate of one-time intubation in patients with AECOPD, shorten the time of intubation, reduce complications, and help to improve the therapeutic effect.