Gaps exist concerning the associations of PM2.5-10, gaseous pollutants, and composite pollutants with the acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The interaction effects of lifestyle factors, indoor air pollution, and meteorological conditions with air pollutants have been underexplored. This time-stratified case-crossover study was nested within the China Kadoorie Biobank cohort study of middle-aged and elderly participants from five urban and five rural areas in China spanning from 2004 to 2018. 10,712 participants were included, each with a mean of 2.3 episodes of AECOPD hospitalizations during the observation period. A composite air pollution score was derived through principal component analysis. Short-term exposure to particulate matter and NO2 was positively associated with hospital admissions for AECOPD, with the largest temperature- and humidity-adjusted odds ratio (95% confidence interval) of 1.101 (1.073, 1.129) at a lag of 1 day for per 1 standard deviation increase in air pollution score. The effect of O3 appeared to be conflicting. The associations were further corroborated by the self-controlled case-series design. Unfavorable body shapes, cold season, and low humidity could exacerbate the influence of air pollution. These findings reinforce the evidence of links between air pollution and AECOPD and implicate the management of body weight and cold and dry circumstances.