The landmark randomised trial by Brochard and colleagues established the value of non-invasive ventilation for selected patients with acute exacerbations of COPD complicated by hypercapnic respiratory failure. Patients receiving non-invasive pressure-support ventilation through a face mask were compared with standard medical therapy. NIV substantially reduced the need for endotracheal intubation and was associated with fewer complications, a shorter hospital stay and lower in-hospital mortality in the study population. The trial provided a practical demonstration that correcting ventilatory failure without an artificial airway can improve outcomes when patients are appropriately selected. Its relevance remains high because acute COPD exacerbations are common and intubation carries important risks, including ventilator-associated complications and prolonged weaning. NIV works best when applied early, monitored closely and accompanied by clear criteria for recognising failure. The findings do not imply that NIV should delay necessary intubation in patients with severe refractory hypoxaemia, inability to protect the airway, profound instability or deteriorating mental status. Instead, the study supports NIV as a first-line strategy for a well-defined phenotype—especially acute-on-chronic hypercapnic respiratory failure—when there is a realistic chance of rapid physiologic improvement. The paper remains one of the foundational studies behind contemporary NIV protocols in COPD.