Objective To investigate the prognostic factors related to in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) . Methods A prospective cohort study was carried out in AECOPD patients admitted in three district general hospitals of Jiangyou city, Sichuan province from February 2007 to February 2008. The clinical and epidemiological data at admission and all-cause death in hospital were recorded. The in-hospital mortality rate and potential determinants of mortality of AECOPD were analyzed using Logistic regression method. Results 257 AECOPD inpatients with AECOPD were recruited into the cohort study. The in-hospital mortality rate was 5.84% (15/257) . Univariate analysis showed in-hospital mortality was significantly associated with age, FEV1% pred, arterial oxygen tension ( PaO2 ) , arterial oxygen saturation ( SaO2 ) , pH, and Charlson’s complication index. Multivariate logistic regression model showed that lower arterial oxygen tension ( OR 4.775;95%CI 1.545 ～14.757; P =0.007) and higher Charlson’s complication index ( OR 4. 608; 95% CI 1. 330 ～15. 966; P =0. 016) were significantly associated with in-hospital mortality after adjustment by age. Conclusion For in-patients with AECOPD, PaO2 and Charlson’s complication index are independent risk factors associated with in-hospital mortality.