Objective：The study compared the basic clinical information and hospitalization outcome of patients with eosinophil and non-eosinophilic inflammation type of acute exacerbation of chronic obstructive pulmonary disease（COPD）in order to guide early and accurate treatment. Methods：The basic clinical data of patients with severe acute exacerbation of COPD（AECOPD）admitted to the First Affiliated Hospital of Nanjing Medical University during 2017 were collected to analyze the differences between EOS-AECOPD and non-EOS-AECOPD groups as well as risk factors related to the condition. Results：There were 63 patients with EOS-AECOPD（25.6%）and 183 patients with non-EOS-AECOPD（74.4%）. The proportion of critically ill patients was 17.5% and 35.5%，respectively. The mortality during hospitalization were 0 and 8.2%，respectively. Multi-regression analysis revealed that EOS ≥ 2% was a protective factor for the severity of the disease，while pulmonary heart disease，respiratory failure and neutrophil to lymphocyte ratio were independent risk factors. Conclusion：Patients with non-EOS AECOPD（PBE＜2%）are more severe，and mortality of hospitalization is higher. The level of eosinophils may help to evaluate the severity of patients with AECOPD in clinical practice so as to guide early and active treatment for critically ill patients.