COPD (chronic obstructive pulmonary disease) is an abnormal narrowing of the airways with progressive and irreversible course. In most cases it occurs between the 5 th. and the 6 th. decade of life. The basics of this disease are the chronic obstructive bronchitis and emphysema. Main symptoms are shortness of breath, cough and sputum, as a result of bronchoepithelial inflammatory response, caused by cigarette smoke in 90 % of all cases, but also through several dust causes. Only 10-20% of all smokers fall ill, because the main reason of emergence is a combination of inhaled noxious agents and genetic factors. COPD can be divided into 4 severities by airway resistance measurement. With increasing severity, exspiratory volume decreases and symptoms such as cough and shortness of breath rise up. At grade 4 shortness of breath already exists at physical rest and the patient partially is dependent of external Oxygen supply. The treatment of COPD can only be run by symptomatics with the aim of palliative. Basic drugs are Anticholinergics and ?2-Sympathomimetics for inhalation. Because of low therapeutic range and serious side effects, Theophylline means the third choice in therapy of COPD. Only a few patients respond treatment with Glucocorticoids. Exacerbation (worsening of the ground state) is usually caused by viral and bacterial infections and requires additional therapy. In dependence of severity, dose of bronchodilators has to be increased. Further more the application of systemic Corticosteroids, Theophylline and Oxygen, are indicated in dependence of severity. If the participation of bacterial involvement is verified, antibiotics are always indicated. Currently COPD takes the 4th. place in the list of most common causes of death in the world, although an advance to place 3 in 2020 is very likely.