COPD is a chronic respiratory disorder that is a major cause of morbidity for patients and carers, and is predicted to be the third leading cause of death worldwide by 2020 (Murray and Lopez, 1997). It is characterised by chronic airflow limitation, airway inflammation, structural changes to the airways and parenchyma and some systemic effects (Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2008). It is primarily caused by smoking, although other causes such as occupational factors have been identified (NICE, 2004). This article aims to provide an overview of some important aspects of acute exacerbations of COPD that need to be considered by all healthcare professionals.