The invention relates to a carbon dioxide laser ventilation optical fiber medical appliance which solves the problems of large volume and small application range of the prior like medical appliance. The carbon dioxide laser ventilation optical fiber medical appliance comprises a tubular base, wherein the lower part of the tubular base is provided with a semiconductor laser, a lower corner is provided with a germanium piece of 45 degrees, the upper part of the tubular base is connected with a bent head of 90 degrees of a coupler of a total reflector of 45 degrees, a tubular inner socket is inserted into the bent head of 90 degrees, a coupler focusing mirror is radially arranged in the inner socket, an outer wall of the coupler focusing mirror is axially and symmetrically provided with a vent groove, the side wall of the coupler focusing mirror is provided with a vent hole which is communicated with the vent groove, the other end of the inner socket is connected with a quick clamping head which clamps a carbon dioxide hollow optical fiber, one end of the carbon dioxide hollow optical fiber extends into the inner socket, the other end of the carbon dioxide hollow optical fiber is connected with a cylindrical cutter handle, the inner radial direction of the cutter handle is provided with a cutter head focusing mirror, four cutter handle vent holes are evenly distributed on the side wall of the cutter handle, and the other end of the cutter handle is connected with a straight tubular type or a turn angle type hollow tubular cutter head. The carbon dioxide laser ventilation optical fiber medical appliance has fine structural volume, the maximum outside diameter of the cutter head is 11.5 millimeters, and laser and gas are transferred into the hollow optical fiber.