Background: To estimate the prevalence of asthma-chronic obstructive pulmonary disease (COPD) overlap among patients of asthma and COPD and to compare its frequency in both groups. Materials and methods: About 200 patients presenting to the out patient department (OPD) and in patient department (IPD) between April 1, 2021 and July 31, 2022 were enrolled and inquired about their symptoms. History regarding smoking, biomass fuel exposure, old pulmonary tuberculosis or a family history of obstructive airway disease was obtained. All these patients performed spirometry and based on GINA-GOLD guidelines, they were diagnosed as asthma, COPD, or asthma-chronic obstructive overlap (ACO). Results: About 125 patients out of a total of 200 were known cases of COPD while 75 were known cases of asthma. Post-spirometry, 112 patients were diagnosed as COPD (56%), 59 as asthma (29.5%) and 29 were labeled as ACO (14.5%). From a total of 125 COPD patients, 13 had ACO which is 10.4%. In contrast out of 75 asthma patients 16 had ACO which is 21.33%. Asthma and ACO patients belonged to a younger age group and COPD patients were older (p-value < 0.001). A male predominance was found among ACO patients with 21.8% of total male patients being diagnosed as ACO while only 5.6% of females were labeled as ACO (p-value 0.001). Conclusion: Asthma-chronic obstructive overlap patients are underdiagnosed and frequently mislabeled as either asthma or COPD. These patients have a male predominance and are younger as compared with COPD patients. Spirometry should be done in all patients having symptoms of obstructive airway disease to make a final diagnosis.