COPD exacerbations are so common in Emergency Department (ED). The vast majority of them are treated in ED because of lack of the ICU and ward beds and they are discharged from ED. So the evidence based management of COPD exacerbation is so important. In this presentation the management of the COPD exacerbation was explained as the availability and the accessibility of drugs and medical equipment in ED. The novel treatment modalities which are suitable for ED were also discussed.