Abstract: Objective To observe the role of noninvasive positive pressure ventilation(NIPPV) with bilevel positive airway pressure(BiPAP)ventilator in the treatment of acute left heart failure. Methods A total number of 112 cases acute left heart failure in our hospital between June,2012 and October,2015 were enrolled and randomly divided into 2 groups.The 58 patients in the treatment group(group BiPAP) received NIPPV with BiPAP on the basis of routine drug for heart failure treatment,while the 54 patients in the control group were only administrated with routine drug for heart failure treatment.The symptoms,signs and hemodynamics of patients were recorded and compared before and after the treatment. Results The significant efficiency was 55.6% in the control group and 72.4% in the treatment group;the total effective rate was 75.9% in the control group and 96.6% in the treatment group;the difference in the significant efficiency and total effective rate was significant between the two groups(P<0.05).There were no significant difference in heart rate,breathing,systolic blood pressure,blood oxygen saturation and blood carbon dioxide partial pressure before the treatment between the two groups(P>0.05);after the treatment,the above indexes in the treatment were significantly better than that of control group(P<0.05). Conclusion BiPAP noninvasive ventilation can avoid complications caused by endotracheal intubation or tracheostomy,improve patient comfort,retainthedefense function of airway and the function of speech and swallowing without interference on breathing,and significantly improve left heart function.It is a kind of safe and effective rescue measures,which is worth popularization in clinic.