Objective To investigate the usage of BiPAP noninvasive positive pressure ventilation in pre-hospital first aid and the effect. Methods A total of 108 patients with any of the following diseases, AECOPD,AHF,ARDS and se-vere bronchial asthma were selected and divided into BiPAP treatment group and routine treatment group according to digital randomized method. Each group included 54 patients. Breath, heart rate, blood gas analysis, changes in hemo-dynamic parameters of two groups before and after treatment and curative effecty were analyzed. Results After treat-ment, breath, heart rate, blood gas analysis, hemodynamic parameters of BiPAP treatment group were better con-trolled than that of conventional treatment group (P < 0.05). The total effective rate of BiPAP treatment group was 92.59%, which was significantly higher than that of the conventional treatment group (P< 0.05). Conclusion The ap-plication of BiPAP in pre-hospital emergency treatment can quickly relieve symptoms and increase curative effect. It is worthy of using widely in clinical treatment.