Chronic obstructive pulmonary disease (COPD) is a preventable and treatable leading cause of worldwide morbidity and mortality that markedly increases healthcare costs. Smoking cessation, vaccinations, supplemental oxygen for hypoxemic patients, and lung volume reduction surgery in selected patients all improve survival; smoking cessation also attenuates disease progression. Several inhaled, oral, and systemically administered drugs improve lung function, decrease the frequency and severity of COPD exacerbations, and improve patients’ quality of life. Pulmonary rehabilitation, noninvasive ventilation, and lung volume reduction also improve outcomes in selected patients. Despite these efforts, COPD continues to claim many lives and disable many more. COPD is a complex process with protean pulmonary and nonpulmonary manifestations punctuated by episodic escalations of respiratory symptoms in a predominately older patient population with multiple comorbid conditions.