Introduction: Chronic obstructive pulmonary disease (COPD) is considered asa major public health concern to the medical community. COPD is associated with episodicexacerbations which are evident as enhanced dyspnea, worsening of lung function, coughand production of sputum. Objectives: To assess 126 COPD exacerbated patients in a tertiarycare hospital of Karachi, Pakistan. Study Design: Descriptive study. Setting: Various wardsof tertiary care Ziauddin Hospitals. Period: November 2016 to April 2017. Methods: Patientswere classified into Type I, II and III exacerbation. Consent was taken from patients’ caregivers,while hospital permission was also obtained. At the time of study all the patients were receivingappropriate therapy and patients were clinically in stable condition. Data collection wasperformed by thorough reviewing and recording the data from patients’ medical records. Also,the questionnaire was filled by the principal investigator to collect three evaluation parametersincluding MMRC Dyspnea Scale Score, Bode Index and Dose Index Scoring System. Datawas expressed in terms of percentages.Direct medical costs were also determined in Rupees(Rs.) of these patients. Results: Results indicated that most of the male patients were foundto have exacerbation. It was found that patients having smoking habits were found to havehigher frequency of COPD exacerbation (Type I, 11 (8.730 %); Type II, 36 (28.571 %); TypeIII, 40 (31.746 %)) as compared to non smokers. Major complaints which were found in 126patients were shortness of breath, fever, cough and increased sputum. It was found that mostcommon comorbid diseases found in 126 patients were hypertension, diabetes mellitus andtuberculosis. In this study, the direct cost analysis of 126 COPD exacerbated patients were alsocarried out. Conclusion: Present study indicated multiple indicators for repeated exacerbationsin COPD. Which in terns increase the treatment costs for the patients.