Currently, the diagnosis of acute exacerbation of chronic obstructive pulmonary disease is a diagnosis of exclusion based on clinical manifestations, because of the lack of biomarkers related to the underlying pathophysiological process.In recent years, chest imaging studies, particularly those with CT scanning, have revealed some potentially useful diagnostic features including increased airway wall area, air trapping and lung vascular changes.Whether these imaging features could be used as imaging biomarkers for the diagnosis and differential diagnosis of acute exacerbation of chronic obstructive pulmonary disease needs further investigation.