Objective To explore the application effect of individualized exercise training combined with airway nursing in elderly patients with acute exacerbation of chronic obstructive pulmonary disease and the influence of lung function exercise tolerance quality of life. Methods A total of 80 elderly patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Zhongshan Hospital affiliated to Dalian University from February 2019 to January 2021 were selected as the study subjects. The patients were divided into study group (40 cases) and control group (40 cases) by random number table method. The study group carried out individualized exercise training combined with airway nursing program, and the control group carried out routine nursing. Lung function, exercise tolerance, quality of life and incidence of complications were compared between the two groups. Results The scores of vitality, body pain, physical function, physiological function, general health, social function, mental health and emotional role of patients in the study group were higher than those in the control group, and the differences were statistically significant (P＜0.05). There were no significant differences in forced vital capacity, peak expiratory flow rate, forced expiratory volume in the first second and exercise tolerance between the two groups before nursing (P＞0.05). After nursing, forced vital capacity, expiratory peak flow rate, forced expiratory volume in the first second and exercise tolerance in the two groups were higher than those before nursing, with statistically significant differences (P＜0.05). The forced vital capacity, expiratory peak flow rate, forced expiratory volume in the first second and exercise tolerance of patients in the study group were higher than those in the control group after nursing, and the differences were statistically significant (P＜0.05). The total incidence of complications in study group was lower than that in control group, and the difference was statistically significant (P＜0.05). Conclusion Individualized exercise training combined with airway nursing can effectively improve lung function, exercise tolerance and quality of life in elderly patients with acute exacerbation of chronic obstructive pulmonary disease.