Abstract: Objective To study how to nurse elderly patients with severe pneumonia accompanying respiratory failure during noninvasive positive pressure ventilation. Methods Clinical data about nursing of 38 elderly patients with severe pneumonia accompanying respiratory failure who were treated with noninvasive positive pressure ventilation from Jan 2005 to Dec 2009 in our hospital and our experience with their nursing were summarized and analyzed. Results After noninvasive positive pressure ventilation treatment,the symptoms of patients were significantly alleviated.The respiratory rate,heart rate and blood gas index of patients were much better after treatment than before treatment（P＜0.05）. Conclusion Rational observation and nursing of elderly patients with severe pneumonia accompanying respiratory failure during noninvasive positive pressure ventilation are of vital importance in improving their symptoms.