Abstract： Objective To summarize clinical characteristics and experience in urgent care of the patients with pulmonary edema after acute severe carbon monoxide (CO) poisoning.Methods Retrospective analyses were made on the clinical data of 13 cases of pulmonary edema after acute severe CO poisoning from Jan.2011 to Apr.2016.Results Forty-eight hours after comprehensive therapy,respiratory indexes of the 12 patients gradually became stable.Respiratory rate after treatment was significantly lower than that before treatment [(20.67 ± 2.53) post treatment vs.(35.92 ± 4.27) bpm before treatment] (P ＜ 0.05).The level of carboxyhemoglobin was significantly decreased [(2.58 ± 1.56) ％ post treatment vs.(29.75 ± 11.29) ％ before treatment] (P ＜0.05),and the level of arterial oxygen tension was significantly increased,as compared with that before treatment [(94.08 ± 14.47) mmHg post treatment vs.(55.50 ± 5.66) mmHg before treatment] (P ＜0.05)(1 mmHg =0.133 kPa).Of the 9 patients who had endotracheal intubation and mechanical ventilation,8 were extubated and one died.Reexamination of pulmonary CT 3-5 days after CO poisoning revealed that pulmonary edema almost disappeared in 10 cases,and high density shadow was still present in 2 patients.Conclusions The main manifestation of lung injury in patients with acute severe CO poisoning was pulmonary edema,which might be accompanied with aspiration pneumonia.Close observation should be made on the signs and symptoms of the patients and timely symptomatic treatment should be given,so as to ensure the safety of patients.