Under the global climate warming, extreme weather events occur more and more frequently. Epidemiological studies have proved that extreme temperature is strongly correlated with respiratory diseases. We evaluated extreme-temperature effect on respiratory emergency room (ER) visits for 5 years in Lanzhou, a northwest temperate climate city of China from January 1st, 2013, to August 31st, 2017. We built a distributed lag non-linear model (DLNM) to evaluate the lag effect up to 30 days. Results showed the relative risk (RR) of respiratory disease always reached the maximum at lag 0 day and decreased to 1.0 at lag 5 days. Extremely low temperature showed the lag effect of 22 days and the maximum RR was 1.415 (95% CI 1.295-1.546) at lag 0 day. Extremely high temperature showed the lag effect of 7 days and the maximum RR was 1.091 (95% CI 1.069-1.114) at lag 0 day. The elders (age > 65 years) were at the greatest risk to extreme temperatures and the response were very acute. Children (age ≤ 15 years) were at the lowest risk but the lag effect lasted the longest lag days than other subgroups. Males showed longer-term lag effect and higher RR than females. Our study indicated that the extremely low temperature has a significantly greater effect on respiratory diseases than extremely high temperature.