AIMS: This research aims to elucidate the association between red cell distribution width (RDW) and the severity of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). PATIENTS & METHODS: This retrospective study enrolled patients with AECOPD and healthy controls. A comprehensive meta-analysis was further conducted by systematically searching PubMed, Embase, and the Cochrane Library up to 27 April 2023. RESULTS: Univariate logistic regression analysis indicated that elevated RDW levels were significantly associated with AECOPD ( CONCLUSION: Elevated RDW levels exhibit a linear positive correlation with AECOPD severity, further supported by meta-analysis.