Objective To explore the predictive value of multi-slice spiral computed tomography CT (MSCT) scanning parameters combined with serum vascular non-inflammatory molecule 1 (Vanin-1) in predicting the prognosis of chronic obstructive pulmonary disease (COPD) in the stable stage. Methods A total of 137 patients with stable COPD who were treated from April 2021 to January 2024 were included in the study group, and 137 healthy subjects who underwent physical examination during the same period were selected as the control group. The MSCT scanning parameters (emphysema index at the end of deep expiration [EIex], percentage of pulmonary small vessels and lung cross-sectional area<5 mm2 [%CSA<5], whole lung volume at the end of deep expiration [Vex], whole lung volume [Vin], volume difference [Vin-Vex], whole lung pixel index at the end of deep expiration [PIex]) and serum Vanin-1 level were compared. Spearman correlation analysis was used to explore the correlation of MSCT scanning parameters, and serum Vanin-1 level with the prognosis of COPD, and the receiver operating characteristic (ROC) curve was drawn to analyze its predictive value for the prognosis. Results The levels of Vex, PIex, EIex and serum Vanin-1 in the study group were significantly higher than those of the control group, and Vin, %CSA<5 and Vin-Vex were significantly lower (P<0.05). Vin, Vin-Vex and %CSA<5 in the mild group were significantly higher than those of the moderate group and the severe group, which, in the moderate group were significantly higher than those of the severe group (P<0.05). The levels of Vex, PIex, EIex and serum Vanin-1 in the mild group were significantly lower than those of the moderate group and the severe group, which were significantly lower in the moderate group than the severe group (P<0.05). The levels of Vin, Vin-Vex and %CSA<5 were negatively correlated with the severity of COPD, and the levels of Vex, PIex, EIex and serum Vanin-1 were positively correlated with the severity COPD (P<0.05). The levels of Vex, PIex, EIex and serum Vanin-1 in the poor prognosis group were significantly higher than those of the good prognosis group, and the levels of Vin, Vin-Vex and %CSA<5 were significantly lower in the good prognosis group (P<0.05). The ROC curve was drawn with patients with poor prognosis as positive samples and those with good prognosis as negative samples. It is found that the area under the curve (AUC) of Vin, Vin-Vex, %CSA<5, Vex, PIex, and EIex combined with serum Vanin-1 levels in predicting the prognosis of COPD was 0.911, with the sensitivity of 92.66%, and the specificity of 82.14%. Conclusion The MSCT scanning parameters and serum Vanin-1 level are closely correlated with the severity of COPD patients, and their combined detection can provide effective reference sfor clinical prediction of the prognosis of COPD.