Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. It is a debilitating airways disease which presents to the ambulance service with varying severity and is characterized by airflow obstruction which is usually progressive, not fully reversible and does not change markedly over several months. It may coexist with other comorbidities such as cardiovascular disease, making diagnosis of exacerbations difficult. COPD management in the prehospital environment is focused on effective recognition and the early application of pharmacological intervention to alleviate symptoms using current Joint Royal Colleges Ambulance Liaison Committee Guidelines.