Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) has high death rate and its hospitalization costs are more than AIDS or tuberculosis. The factors causing exacerbation are largely unknown. This study is aimed to make sense of the fatality risk factors associated with AECOPD and find the measures to take early intervention to reduce the mortality; the present study was to make a retrospective analysis of clinical data of in patients with AECOPD. Totally 4624 cases were collected, who were admitted into the 2nd hospital of Hebei medical university for AECOPD from January 2005 to December 2014. Among them, 314 cases (6.8%, death group) died during hospitalization vs. 4310 cases (93.2%, survival group) survived finally. To identify the fatality risk factors, T test, chi-square test, Logistic regressions were used by SPSS19.0 software. Different factors were assessed by Odd Ratio (OR) value and the results were displayed in a descending order as follow: elevated PaCO2, complication, mechanical ventilation, supportive care, the damage of lung function, PaO2, pulmonary infection, the frequency of acute attack, the length of illness course, Body Mass Index (BMI), age. The death of AECOPD is up to the synergistic effect of the fatality risk factors presented above and as a result, systematic care and multiple organ supportive therapy seem especially important in the prognosis effect of AECOPD patients.