Chronic obstructive pulmonary disease (COPD) is a leading cause of disability and death. Prevalence rates are related to tobacco smoking and indoor air pollution, and are expected to rise as smoking rates continue to increase among women and in developing countries. By 2030, COPD is expected to represent the third leading cause of death. Caring for patients with advanced disease who experience frequent exacerbations places a significant burden on health care resources. Evidence on the natural history of COPD demonstrates early institution of long acting bronchodilator therapy slows the rate of lung function decline and reduces frequency of exacerbations that can lead to further functional decline. The goals of therapy are symptom control, reduce exacerbations, and maintain quality of life. Smoking cessation, pharmacotherapy with long acting bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and palliative care are important components. This review highlights current guidelines and management strategies for COPD.