Chronic obstructive pulmonary disease (COPD) is a common pulmonary disease in elderly, in which the pulmonary respiratory mechanics has gradually changed, while surgery, general anesthesia and conventional mechanical ventilation will seriously affect the pulmonary respiratory mechanics of COPD patients, which are more likely to have severe perioperative pulmonary complications. Therefore, according to the features of the respiratory mechanics of COPD patients and the characteristics of changes in respiratory mechanics during mechanical ventilation, to select individualized ventilation strategies to improve their respiratory mechanics and apply different monitoring methods to optimize the interaction between human and ventilator during ventilation of COPD patients for achieving the purpose of lung protection are very important for patients with COPD during the perioperative period. This review describes in detail the physiological status of the patients with COPD patients and the characteristics of respiratory mechanics during mechanical ventilation, and through the summary and discussion of recent literature, describes different ventilation strategies and various respiratory mechanics monitoring methods in COPD patients in recent years. It is expected to provide new ideas and references for the ventilation management of COPD patients who require mechanical ventilation in clinical practice.