BACKGROUND: Non-invasive ventilation (NIV) is the delivery of positive pressure ventilation through an interface to upper airways without using the invasive airway. Use of NIV is becoming common with the increasing recognition of its benefits. OBJECTIVES: This study was done to evaluate the feasibility and outcome of NIV (BiPAP) in Type II Respiratory Failure in Department of Pulmonary Medicine, Kurnool Medical College. Materials and Methods: An observational study conducted over a period of 18 months in Department of pulmonary medicine, Kurnool Medical College in 40 patients who were treated by NIV (BiPaP). Patients were stratified on basis of set of exclusion and inclusion criteria. NIV was given in accordance with the arterial blood gas (ABG) parameters defining Type II respiratory failure. RESULTS: In the present study NIPPV was successful in 34(85%) and failed in 6(15%) patients. The most common indication of NIV in our hospital was acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) 90% and 88% of AE-COPD patients were improved by NIV. Application of NIV resulted in significant improvement of pH and blood gases in COPD patients. Kyphoscoliosis, Obstructive Sleep Apnea (OSA) patients with Type II Respiratory failure also showed significant improvement in partial pressure of oxygen and carbon dioxide. CONCLUSION: This study demonstrates and encourages the use of NIV as the first-line ventilator treatment in AE-COPD patients with Type II respiratory failure. It also supports NIV usage in other causes of type II Respiratory failure as a promising step toward prevention of mechanical ventilation.