In general chronic obstructive pulmonary disease (COPD) can be diagnosed in family practice from history and spirometry. Inconclusive spirometry findings have to be assessed further by techniques available in a pulmonologist's office. Further testing is done for differential diagnostic reasons and for prognostic appraisal. Successful smoking cessation importantly alters the natural downhill course of the disease. Patient education and rehabilitative interventions (e. g. participation in lung sport groups) help to improve life quality. Medical therapies with bronchospasmolytics applied by inhalation as monotherapies, free and fixed combinations have symptomatic benefit. Considering the increase of pneumonia risk from inhaled corticosteroids their use should be restricted to patients with a straightforward indication, e. g. coexisting asthma.