Chronic obstructive pulmonary disease (COPD) is a progressive condition characterised by reduced inspiratory and expiratory capacity of the lungs. COPD is not fully reversible and is a common cause of death in the UK. It is difficult to predict when a patient with COPD has end-stage disease and requires palliative care. Patients with COPD are less likely to receive palliative care than those with cancer. The need to discuss treatment options, palliative care and end of life care with these patients is important, although it is acknowledged that these discussions can be difficult for patients and healthcare professionals.