The goals of therapy for chronic obstructive pulmonary disease include relieving symptoms, improving abnormal physiology, and limiting complications, including abnormal gas exchange and exacerbations of the disease. This review summarizes current guidelines and provides recommendations for management, including assessment of lung function, preventive measures, stepwise medical therapy, and pulmonary rehabilitation and surgical therapy. By the time this disease becomes symptomatic, the forced vital capacity of most patients has already declined by about 50 percent.