〔Abstract〕 Objective To explore the clinical characteristics and prognosis of pulmonary fungal infection in elderly patients with acute exacerbation of chronic obstructivepulmonary disease (AECOPD). Methods A total of 220 elderly AECOPD patients admitted to the First Affiliated Hospital of Xiamen University from March 2020 to March 2023 were selected as the research subjects. The number of cases of pulmonary fungal infection in elderly AECOPD patients was counted, the incidence of pulmonary fungal infection was calculated, the distribution of pathogens and clinical characteristics of patients were analyzed, and patients were divided into infected and uninfected groups. The prognosis differences between the two groups of patients were compared. Results Pulmonary fungal infection occurred in 46 of 220 AECOPD patients (20.91%). A total of 72 fungal strains were isolated, of which Candida albicans and Candida tropicalis were the main strains. The main features of chest computed tomography (CT) in 46 patients with pulmonary fungal infection were nodular halo sign, nodular shadow, mass shadow, cavity, etc. The main clinical symptoms were dyspnea, fever, cough and sputum, chest pain, dry cough, lung rales and so on. Follow-up 6 months after treatment, the re-hospitalization rate and fatality case rate of infected group were higher than those of the uninfected group, the difference was statistically significant (P < 0.05). Conclusion Elderly AECOPD patients develop secondary pulmonary fungal infections, mainly caused by Candida albicans and Candida tropicalis. The CT features of the patients include nodular halo sign, nodular shadow, mass shadow, and cavity. The clinical symptoms include difficulty breathing, fever, cough and sputum, chest pain, dry cough, and lung rales, and the combination of pulmonary fungal infections can affect the prognosis of the patients.