Objective: To investigate the prognostic value of diastolic blood pressure in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: According to the diastolic blood pressure level, 70 patients with AECOPD hospitalized in the People"s Hospital of Pingxiang City from September 2024 to March 2025 were divided into low diastolic blood pressure group (n=10), normal diastolic blood pressure group (n=38) and high diastolic blood pressure group (n=22), and the general data of the three groups were compared. After a 3-month follow-up, patients with AECOPD were divided into the survival group (n=54) and the death group (n=16) based on the survival prognosis. Multivariate Cox regression was used to analyze the independent factors affecting the survival prognosis of hospitalized patients with AECOPD;Kaplan-Meie curve was used to analyze the effect of diastolic blood pressure on survival and prognosis of hospitalized AECOPD patients.Results: There were differences in age, BMI, COPD classification, heart rate, systolic blood pressure, C-reactive protein, neutrophils, arterial partial pressure of oxygen, oxygenation index, left ventricular ejection fraction, FEV1 and forced vital capacity among the three groups of patients (P<0.05);The results showed that age, AECOPD grading, heart rate, systolic blood pressure, diastolic blood pressure, neutrophil and oxygenation index were the influencing factors for survival and prognosis of patients with AECOPD(P<0.05);Cox multivariate analysis showed that old age, extreme severity of AECOPD, large heart rate, high systolic blood pressure, low diastolic pressure, elevated neutrophils, and low oxygenation index were independent influencing factors for poor survival and prognosis of inpatients with AECOPD (P<0.05).Kaplan-Meie curve showed that there was no significant difference in mortality between normal diastolic blood pressure group and high diastolic blood pressure group (P>0.05). The mortality rate of low diastolic blood pressure group was significantly higher than that of normal diastolic blood pressure group and high diastolic blood pressure group (P<0.05). Conclusion: Inpatients with low diastolic blood pressure AECOPD had a higher mortality rate.