Objective To observe the application effect of targeted nursing on the elderly patients with chronic obstructive pulmonary disease (COPD) in ICU. Methods From October 2017 to October 2019, 144 elderly patients with Ⅱ, Ⅲgrade COPD and infection in ICU were selected as the research objects. They were divided into control group (n=72)and experimental group (n=72) according to random number table method. The patients in the control group received routine nursing intervention, while the patients in the experimental group received targeted nursing intervention. Before and after the intervention, the blood gas indexes, respiratory rate, ICU treatment time, treatment weaning rate and ICU transfer rate were compared between the two groups. Results There was no significant difference of blood gas indexes between the two groups (P＞0.05). After intervention, the partial pressure of carbon dioxide (PaCO2) in the experimental group was lower than that in the control group, and PaO2, hydrogen carbonate (HCO3-) and oxygen saturation of blood(SaO2) in the experimental group were higher than those in the control group, the differences were statistically significant (P<0.05). There was no significant difference in respiratory rate between the two groups before intervention (P＞0.05). After intervention, the respiratory rate of patients in the experimental group was lower than that in the control group, and the duration of ICU treatment in the experimental group was shorter than that in the control group, the differences were statistically significant (P<0.05). The weaning rate in the experimental group was 88.89%, which was higher than 65.28% in the control group, while the ICU transfer rate in the experimental group was 94.44%, which was higher than 77.78% in the control group, the differences were statistically significant (P<0.05). Conclusion Targeted nursing intervention can significantly improve the levels of blood gas indexes, reduce the respiratory rate, shorten the time for ICU patients to receive treatment, increase the off-line rate of treatment, and improve the ICU transfer out rate after the improvement.