COPD is a progressive disease associated with exposure to noxious gases or particles, most notably, tobacco smoke. Symptoms often mimic those of asthma and other pulmonary diseases, which can make diagnosis challenging. An exacerbation, defined as an acute change in the patient's baseline condition, can be caused by infections and air pollution, although the cause of up to one-third of exacerbations is unknown. Management of exacerbations is a crucial part of managing patents with COPD. This program will present the role of spirometry in the long term management of the patient with COPD.