Objective: To investigate the relationship between serum levels of autophagy associated gene 7 (ATG7), interleukin 17 (IL-17) and nitric oxide (NO) and the disease and outcome of emergency pneumonia with respiratory failure. Methods: 62 patients with emergency pneumonia with respiratory failure admitted to our hospital from March 2022 to October 2024 were included in the observation group. Another 59 patients with simple emergency pneumonia treated in our hospital during the same period were included in the control group, and 65 healthy patients who underwent physical examination in our hospital were included in the health group. Serum levels of ATG7, IL-17 and NO were detected and compared among the three groups. According to the severity of disease, the observation group was divided into mild group (33 cases) and severe group (29 cases). According to the outcome of the patients, the observation group was divided into a good outcome group (51 cases) and a bad outcome group (11 cases). The serum levels of ATG7, IL-17 and NO were compared in patients with different severity and different outcomes. The correlation of serum ATG7, IL-17 and NO with disease severity and outcome was analyzed by Preason. Results: The levels of serum ATG7 and IL-17 in observation group were significantly higher than those in control group and healthy group (P < 0.05), and the level of NO was significantly lower than that in control group and healthy group (P < 0.05). The levels of serum ATG7 and IL-17 in control group were significantly higher than those in healthy group (P < 0.05), and the level of NO was significantly lower than that in healthy group (P < 0.05). The levels of serum ATG7 and IL-17 in severe group were significantly higher than those in mild group (P < 0.05), and the level of NO was significantly lower than that in mild group (P < 0.05). The levels of serum ATG7 and IL-17 in the poor outcome group were significantly higher than those in the good outcome group (P < 0.05), and the level of NO was significantly lower than that in the good outcome group (P < 0.05). Pearson correlation analysis showed that serum ATG7 and IL-17 levels were positively correlated with the severity and adverse outcome of emergency pneumonia with respiratory failure (P < 0.05), while serum NO level was negatively correlated with the severity and adverse outcome of emergency pneumonia with respiratory failure (P < 0.05). Conclusion: Serum ATG7, IL-17 and NO are closely related to the condition and outcome of emergency pneumonia with respiratory failure.