Ｏｂｊｅｃｔｉｖｅ　To explore the effect of subcutaneous emphysema due to retroperitoneal laparoscopic carbon dioxide pneumoperitoneum on hemodynamic， arterial blood gas， and awakening time in patients undergoing nephrectomy surgery.　Methods　Eighty-seven patients with kidney cancer scheduled for radical nephrectomy surgery were retrospectively studied. Patients were divided into three groups according to the severity of subcutaneous emphysema： patients without subcutaneous emphysema group（group A， n=66）， patients with grade 1 or 2 subcutaneous emphysema group（group B， n=15）， and patients with severe subcutaneous emphysema in grade 3 group（group C， n=6）. Group B and group C were treated by excessive ventilation. At the time before pneumoperitoneum （T0）， 30 （T1）， 60（T2），90 min（T3） after CO2 insufflation， the end of operation（T4）， and 30 min after tracheal extubation， arterial blood gas analysis， end?蛳tidal carbon dioxide partial pressure（PETCO2）， heart rate（HR）， and mean artery pressure（MAP） were recorded. The time of awake were also observed.　Results　At T2-T4 time point， partial pressure of carbon dioxide in artery（PaCO2）， PETCO2， HR， MAP in group C were significantly higher than those in group A（P<0.05）. At T2-T4 time point the pH in group C were significantly lower than that of group A（P<0.05）. The time of call can open eyes after surgery in group C［（16±6） min］ were significantly longer than that of group A［（11±3） min］（P＜0.05）. The time of orientation recovery in group C［（30±7） min］ were significantly longer than that of group A［（23±6） min］（P＜0.05）. At extubation and 30 min after extubation， PaCO2 in group C［（52±7），（48±7） mmHg（1 mmHg=0.133 kPa）］ were significantly higher than that of group A［（45±4），（39±4） mmHg］（P<0.05）.　Conclusions　Severe subcutaneous emphysema may lead to hypercapnia， elevate blood pressure and HR， and postpone the awake time.