Objective: Exploring the effect of non-invasive bi level positive airway pressure ventilation (BiPAP) in chronic obstructive pulmonary disease (COPD) with type II respiratory failure. Methods: Sixty patients with COPD combined with type II respiratory failure admitted to Huangjiasi Hospital in Yushan County from January 2023 to December 2024 were randomly divided into two groups by drawing lots. The control group received conventional treatment, while the experimental group received combined treatment with BiPAP. Blood gas indicators, inflammatory indicators, and clinical prognosis were compared between the two groups. Results: After treatment, the experimental group"s partial pressure of carbon dioxide (PaCO ?) hs-CRP、IL-6、TNF-α、 All were lower than the control group, and the blood oxygen partial pressure (PaO ?) and oxygenation index (PaO ?/FiO ?) were higher than the control group (P<0.05); The hospitalization time of the experimental group was shorter than that of the control group (P<0.05), and there was no significant difference in tracheal intubation rate, readmission rate, and 28 day mortality rate (P>0.05). Conclusion: BiPAP non-invasive ventilator can effectively improve oxygenation status and inflammatory factor levels, promoting the recovery of COPD patients with type II respiratory failure.