Non-invasive lung ventilation (NILV) is one of the most up-to-date methods of respiratory support at acute respiratory failure (ASF). The study is devoted to evaluation of efficacy, safety and tolerance (comfort) of this treatment mode for the patient. NIVL was carried out in 483 patients divided into 5 groups against the leading etiopathogenetic development mechanism of ASF. The greatest success of NIVL was achieved in the groups of patients with acute left ventricle failure and respiratory failure with restrictive-like ventilation disturbances. The greatest frequency of complications was noted in groups of patients with acute parenchymatous lung damage and chronic obstructive lung disease. Use of NILV allows to improve gas exchange indices and mechanical property of lungs noticeably. This treatment mode is an efficacious and safe enough alternative to intubation of trachea in patients with ASF in resuscitation units of multiply-discipline surgical hospitals.