〔Abstract〕 Objective To analyze the clinical efficacy of early use of low molecular weight heparin in acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A total of 100 patients with AECOPD admitted to the First Affiliated Hospital of Zhengzhou University from June 2021 to June 2022 were selected, fifty patients receiving conventional treatment were included in the control group, and fifty patients receiving early treatment with low molecular weight heparin combined with conventional treatment were included in the observation group. Respiratory status, blood routine, inflammatory factors, vascular endothelial function and hemorheology related indexes and treatment-related adverse reactions were compared between the two groups. Results After treatment, the ratios of neutrophil/lymphocyte and platelet/lymphocyte in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the levels of interleukin-6 and tumor necrosis factor-α in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the level of endothelin-1 in the observation group was lower than that of the control group, and the level of nitric oxide was higher than that of the control group, the differences were statistically significant (P < 0.05). After treatment, the levels of hematocrit, plasma viscosity and whole blood high tangential viscosity in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). After treatment, the dyspnea score of the observation group was lower than that of the control group, and the difference was statistically significant (P < 0.05). No adverse reactions occurred in the two groups. Conclusion Patients with AECOPD should be treated with low molecular weight heparin as early as possible, which is helpful to relieve hypercoagulability, protect vascular endothelial function and control the degree of inflammation in the body.