Objective To investigate the influence of abnormal lipid metabolism on prognosis and quality of life in patients with severe COPD. Methods 134 patients with severe COPD in our hospital from September 2013 to January 2015 were selected as research objects, and their blood lipid levels were detected. The patients were divided into the normal group (n=61) and the low level group (n=73) according to the test results of lipid levels. 1-year mortality rate was statistically analyzed in both groups , and the WHOQOL-BREF health survey profile was applied to assess quality of life before and after treatment. Results 1-year survival rate in the normal group was 90.16%(55/61), which was higher than 73.97%(54/73) in the low level group (χ2=5.741, P=0.017). As compared with the normal group, the scores on physiological function, environment, social relationship, mental state, spirit / religious / belief, and total quality of lifewere markedly lower in the low level group after treatment (P < 0.05). The correlation analysis showed that plasma levels of TC, TG, and HDL-C were negatively correlated with 1-year mortality rate in patients with severe COPD (P < 0.05) but positively related with all dimensions in quality of life; plasma HDL-C level was positively related with 1-year mortality rate (P < 0.05), but negatively related with all dimensions in quality of life in patients with severe COPD (P < 0.05). Conclusions For patients with severe COPD, abnormal lipid metabolism is closely related with prognosis and quality of life. We should pay attention to nutritional support and control of abnormal lipid metabolism in those patients , leading to improvement of prognosis and quality of life.