Abstract: Objective To evaluate the survive of hospitalized AIDS patients complicated with severe pneumocystis carinii pneumonia(PCP) and provide evidence for the development of treatment schedule and clinical drug use. Methods A retrospective analysis was conducted on the AIDS cases complicated with severe PCP hospitalized in our hospital from March 2007 to June 2012 to know their survival time according to their CD4+ cell count and under different treatments received. Results Totally 30 AIDS cases complicated with severe PCP were analyzed, in which 25 died, 5 survived. Sixteen cases were treated with simple Trimethoprim+Sulfamethoxazole(TMP-SMZ), 14 died, the case fatality was 87.5%. Fourteen cases were treated with TMP-SMZ plus prednisone, 11 died, the case fatality was 78.57%. According to the CD4+ cell counts,the survival rate of the patients treated with TMP-SMZ plus prednisone were higher than that of those received only TMP-SMZ; According to the treatment received,the survival rate of the patients with CD4+cell count4+cell count>50/μl. Conclusion The case fatality of AIDS patients complicated with severe PCP is high, it is critical to give them early discovery, diagnosis and treatment. The efficiency of TMP-SMZ plus prednisone is better than simple TMP-SMZ.