Objective To explore clinical features and risk factors for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with overweight.Methods In this prospective cross-sectional study, 284 patients with AECOPD were enrolled from July 2022 to January 2023. The patients were divided into normal weight group (BMI 18.5~23.9, n=180) and overweight group (BMI ≥24, n=104). Demographic data, underlying diseases, inflammatory parameters, blood routine, arterial blood gas (ABG), renal function, and lung function were collected. Binary logistics regression was performed to explore the independent risk factors for overweight in patients with AECOPD. Furthermore, nomogram and its-associated curves were utilized to verify and visualize the model. Results Univariate analysis showed that smoking, the rates of type 2 diabetes (T2DM), coronary artery disease (CAD) and essential hypertension, and alanine aminotransferase (ALT) were significantly different between two groups (P in all <0.05). Subsequently, a binary logistic regression model identified that current-smoking, the rate of T2DM, and ALT were independent variables of overweight in AECOPD patients. Additionally, the result of binary logistic regression was visualized and verified by nomogram and its-associated curves. Then, the mean absolute error (MAE) of calibration curve and the AUC of ROC curve were 0.02 and 0.658, respectively. The DCA curve revealed that the nomogram had more clinical benefits if the threshold at a range of 0.15~0.78. Conclusion Collectively, this study found that compared to normal weight AECOPD, overweight AECOPD patients had less smoking. Meanwhile, T2DM and essential hypertension were more common, and ALT was higher in AECOPD patients with overweight than those with normal weight. These results indicate that AECOPD patients with overweight are inclined to combine with more comorbidities, potentially leading to worse outcomes. Therefore, advanced management and clinical care should be given to AECOPD patients with overweight