Aim: we conducted this study to evaluate the effect of high-velocity nasal cannula (HVNC) compared with noninvasive positive pressure ventilation (NIPPV) in reducing the need for endotracheal intubation in patients with respiratory failure due to COPD exacerbation and the outcome in both methods. Patients and methods: Our study is a randomized controlled trial that was conducted on patients admitted to the ICU by COPD exacerbation in the critical care department and chest department in Beni-Suef University, from February 2022 to January 2023, with a sample size of 40 patients divided into two groups, group (A) consists of 20 patients subjected to NIPPV, and group (B) consists of 20 patients subjected to HVNC.  Results: SO₂ significantly increased from 1st hour (80.8±7.9%) to 2nd hour (93.9±1.5%). PH increased significantly in both groups, with no significant difference between the two groups after 2 hours. PCO₂ decreased significantly in both groups, with more improvement in HVNC. PO₂ and HCO₃ didn't differ significantly after 2 hours, and there were no significant differences between the two groups. There were insignificant differences between the studied groups regarding the need for intubation, mortality, length of stay, and SAPS score, but the Borg scale was higher in the NIPPV group than the HVNC group.  Conclusion: in conclusion, both HVNC and NIPPV are effective in COPD exacerbation in decreasing the carbon dioxide with more improvement in the HVNC group. There was a significant role of HVNC in decreasing intolerance and respiratory distress and the Borg dyspnea scale.