Noninvasive positive pressure ventilation (NPPV) has been shown to be an effective modality for the treatment of acute or chronic respiratory failure in patients with chronic obstructive pulmonary diseases (COPD). Interest in NPPV has grown in recent years with the development of comfortable and effective masks, but the selection of an appropriate patient/ventilator interface may play a key role. Currently a variety of disposable NPPV masks are available, classified broadly as either nasal mask or face mask. Here, a case with COPD whose respiratory acidosis improved by total-face mask (TFM) was presented, and therefore we discussed the efficacy of TFM in acute respiratory failure.