Objective To evaluate treatment efficacy of the invasive mechanical ventilation in elderly patients with acute left ventricular failure and severe pulmonary edema. Methods 52 cases of elderly patients with acute left ventricular failure and pulmonary edema treated in our hospital from June 2013 to June 2015 were selected as the research object. Through patient invasive mechanical ventilation, heart rate analysis after the patient ventilation, blood pressure changes in respiratory rate and other indicators. Results The patient 6h, 12h, 48h after ventilation therapy, observed the patients have been effectively improved, showing improving trends. There are 47 patients were successful have invasive mechanical ventilation weaning of 90.38%. In 5 patients with ventilation success but there is a mechanical ventilation weaning failure (died in 4 patients weaning process. 1 patients weaning failure into surgery, the mortality rate was 7.69%. Conclusion To give elderly patients with acute left heart failure patients with severe pulmonary edema and invasive mechanical ventilation in the treatment, can effectively reduce the mortality rate, clinical curative effect better value to popularization and application.