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Background Nutrition usually affects the outcome of critically ill patients with chronic obstructive pulmonary disease (COPD). Aim The aim of the work was to detect the effect of calculated nutritional regimen on outcome of critically ill patients with COPD in comparison with patients who received conventional nutrition. Patients and methods This prospective analytic case–control study included 40 patients with COPD who were intubated and mechanically ventilated and received enteral nutrition in the ICU of Chest Department in Assiut University Hospitals. They were divided into group 1, who underwent conventional nutrition regimen, and group 2, who undergoing adjusted and calculated regimen. Results Duration of mechanical ventilation was significantly prolonged in those patients on conventional nutrition in comparison with those with calculated nutrition (9.50±4.35 vs 6.80±3.01; P=0.02). No weaning occurred in most patients (50%) with conventional therapy, but 75% of those with calculated nutrition had simple weaning (P=0.01). Conclusion Nutritional assessment followed by management by calculated regimen shortens the duration of mechanical ventilation (MV), enhances easy weaning, and improves pulmonary function (forced expiratory volume in first second) and outcome of critically ill patients with COPD.