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Background Acute exacerbations are associated with significant morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Identification of mortality predictors in severe COPD exacerbations may be of use in clinical decision making and prognostication. Objective The aim was to determine the in-hospital mortality rate, predictors of 30-day mortality, and duration of mechanical ventilation in patients admitted to the ICU with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Materials and methods This was an observational study conducted in a tertiary care hospital. Patients with acute exacerbation of COPD needing ICU admission were included. A standardized questionnaire was prepared to collect information about included patients. Outcomes of interest were total duration of hospital stay, ICU stay or death. SPSS version 11 was used for the statistical analysis. Results A total of 63 patients were enrolled in the study, out of which 22 (34.9%) died. Sepsis with multiorgan failure was commonest cause of the death. The risk factors associated with increased mortality in univariate analysis were pH less than 7.25, lymphocyte counts of less than 10%, platelet counts less than 1.5 lac, blood urea greater than 40 mg/dl, and need of mechanical ventilation. Multivariate analysis was conducted for those with statistically significant P value in univariate analysis. It showed thrombocytopenia, hypotension, hypercapnea, and uremia were independent predictors of increased mortality. Conclusion The present study revealed a mortality rate of 34.9% in patients with AECOPD needing ICU admission. Thrombocytopenia, hypotension, hypercapnea, and uremia were independent predictors of increased mortality. The results may be useful in the prognostication of patients with AECOPD needing ICU admission.