Chronic obstructive pulmonary disease is a complex disease, with both pulmonary and systemic manifestations. There is an increased risk of serious comorbidity and mortality. Although chronic obstructive pulmonary disease is most often progressive, both pharmacological and non-pharmacological interventions significantly ameliorate the severity and impact of symptoms, and reduce the frequency of exacerbations. Stopping smoking and pulmonary rehabilitation are key interventions. Mild symptoms are managed with short-acting inhaled bronchodilators. One or two long-acting bronchodilators are added if symptoms persist. The role of inhaled corticosteroids is being questioned as they may not benefit all patients. Optimal therapy includes reviewing patients' inhaler use, and ensuring they have a self-management plan that enables them to promptly start treatment of infection and exacerbations. In future, treatment is likely to combine a multidimensional management approach with tailored treatment and clinical phenotyping.