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Aim: To compare invasively mechanically ventilation (IMV) for acute respiratory failure patients with obstructive (OLD) and restrictive (RLD) lung disease. Material and Methods: In this retrospective cohort study, 79 patients (OLD: 52, RLD: 27) were chosen from 122 patients, mechanically ventilated over 24 hours in a respiratory critical care unit, between January 2004 and December 2005. The clinical and demographic charateristics at the beginning, arterial blood gases and APACE II results before intubation, on the weaning day, extubation time and day of discharge from the critical care unit, total IMV duration, critical care days are compared by means of mortality and complication rates. Results: The mean age was 62±14 while the gender variation was F/M: 23/56. In the OLD group, age and HCO3 ( initial) results were higher (p=0.01, p=0.054) while respiratory rate and oxygen saturation results were lower (p=0.04, p= 0.053) than in the RLD group. Gender, comorbidity and the other initial results were similar in both groups. In the RLD group, the PaO2 results and APACHE II scores before extubation were lower (p=0.046, p=0.02). The extubation failure rate was 63% in the RLD group, and 8.5% in the OLD group (p=0.03). Total IMV and critical care unit duration, complications and mortality rates were similar. Conclusion: Noninvasive mechanical ventilation is recommended immediately after extubation of acute respiratory failure patients with RLD, as extubation failure rates are higher in these patients than in the OLD patients. [ABSTRACT FROM AUTHOR]