ObjectiveTo explore the predisposing factors in the development of acute respiratory failure after abdominal surgery and the factors affecting the therapeutic effect of mechanical ventilation. MethodsA retrospective study was undertaken for acute respiratory failure after abdominal surgery in 91 patients. The underline diseases, introducing causes and efficacy of mechanical ventilation were retrospectively analysed. ResultsPostoperative pneumonia was the cause of acute respiratory failure in 53 cases and ARDS caused by severe abdominal infection and severe acute pancreatitis in 38 cases. Of the 91 cases, complicated with COPD in 38 cases, severe malnutrion 32 cases, and hypokalemia 14 cases. Respiratory failure occurred at（4.08±2.45）days after operation. The duration of mechanical ventilation was（21.66±21.42）days; 33 cases died, and 58 cases were successfully recovered with mechanical ventilation.ConclusionsThe management of acute respiratory failure after abdominal asurgery should be rational use of mechanical ventilation, adjustment of weaning strategy and avoidance of dependance on mechanical ventilation. Timely treatment of the primary disease, effective control of abdominal infection and aggressive symptomatic and supportive treatment are factors that affect the success or failure of mechanical ventilation.