Background:　Chronic　obstructive　pulmonary　disease　(COPD)　with　carbon　dioxide　retention　is　associated　with　a　worsening　clinical　condition　and　the　beginning　of　pulmonary　ventilation　decompensation.　This　study　aimed　to　identify　the　factors　associated　with　carbon　dioxide　retention.　Methods:　This　was　a　retrospective　study　of　consecutive　patients　with　COPD　(meeting　the　Global　Initiative　for　Chronic　Obstructive　Lung　Disease　diagnostic　criteria)　hospitalized　at　The　Ninth　Hospital　of　Xi＇an　Affiliated　Hospital　of　Xi＇an　Jiaotong　University　between　October　2014　and　September　2017.　The　baseline　demographic,　clinical,　laboratory,　pulmonary　function,　and　imaging　data　were　compared　between　the　86　cases　with　carbon　dioxide　retention　and　the　144　cases　without　carbon　dioxide　retention.　Results:　Compared　with　the　non-carbon　dioxide　retention　group,　the　group　with　carbon　dioxide　retention　had　a　higher　number　of　hospitalizations　in　the　previous　12　months　(p　=　0.013),　higher　modified　Medical　Research　Council　(mMRC)　dyspnea　scores　(p　=　0.034),　lower　arterial　oxygen　pressure　(p　=　0.018),　worse　pulmonary　function　(forced　expiratory　volume　in　one　second/forced　vital　capacity　[FEV1/FVC;　p　＜　0.001],　FEV1%pred　[p　＜　0.001],　Z5%pred　[p=　0.004],　R5%pred　[p　=　0.008],　R5-R20　[p　=　0.009],　X5　[p　=　0.022],　and　Ax　[p　=　0.011]),　more　severe　lung　damage　(such　as　increased　lung　volume　[p　=　0.011],　more　emphysema　range　[p　=　0.007],　and　lower　mean　lung　density　[p=　0.043]).　FEV1　＜　1　L　(odds　ratio　[OR]　=　4.011,　95%　confidence　interval　[CI]:　2.216-7.262)　and　emphysema　index　(El)　＞　20%　(OR　=　1.926,　95%　CI:　1.080-3.432)　were　independently　associated　with　carbon　dioxide　retention　in　COPD.　Conclusion:　Compared　with　the　non-carbon　dioxide　retention　group,　the　group　with　carbon　dioxide　retention　had　different　clinical,　pulmonary　function,　and　imaging　features.　FEV1　＜　1　L　and　El　＞　20%　were　independently　associated　with　carbon　dioxide　retention　in　AECOPD.