Abstract: Objective To investigate the risk factors and nursing strategies of acute respiratory failure after pneumonectomy. Methods Eighty-eight patients with pneumonectomy from April,2015 to February,2016 were selected and divided into respiratory failure group and no respiratory failure group according to with or without acute respiratory failure after operation.The data of two groups were collected,including general information (gender,age,smoking index,cardiovascular history),preoperative pulmonary function[FVC,1 second expiratory volume(FEV1),max(MVV),forced expiratory volume(FEV1/FVC)],surgical methods(part lung resection,pneumonectomy),fluid volume(intraoperative fluid volume,postoperative day fluid volume),and were analyzed by univariate analysis and logistic regression analysis. Results The incidence of acute respiratory failure after pneumonectomy was 31.8%.Univariate analysis and logistic regression analysis results showed that age,smoking index,cardiovascular history,FVC<1.8 L,FEV1<1.5 L,FEV1/FVC<70%,operation mode,intraoperative fluid volume,postoperative fluid volume were postoperative risk factors for acute respiratory failure. Conclusion Postoperative acute respiratory failure easily occurred in patients with pneumonectomy,with age,smoking index,cardiovascular history,FVC<1.8 L,FEV1<1.5 L,FEV1/FVC<70%,operation mode,intraoperative fluid volume,postoperative fluid volume as postoperative risk factors for acute respiratory failure.The risk factors of ARF should be paid attention to in clinical work,and prevention and treatment should be carried out.