The article provides an overview of chronic obstructive pulmonary disease (COPD) exacerbations, their causes, and prevention strategies. COPD exacerbations are episodes of worsening symptoms, leading to significant morbidity and mortality. They are primarily triggered by respiratory viruses and bacteria, causing increased airway and systemic inflammation. Patients with frequent exacerbations have worse health outcomes, including higher hospital admission rates and mortality. Pharmacological interventions such as inhaled steroids, long-acting bronchodilators, and their combinations have shown effectiveness in reducing exacerbation frequency and severity. Non-pharmacological therapies like pulmonary rehabilitation, self-management, and home ventilatory support are also important but require further study. The future of exacerbation prevention lies in optimizing combinations of pharmacological and non-pharmacological therapies to improve health status and reduce hospital admissions and mortality. The article highlights the need for new interventions and well-designed randomized trials to further reduce the burden of COPD exacerbations.The article provides an overview of chronic obstructive pulmonary disease (COPD) exacerbations, their causes, and prevention strategies. COPD exacerbations are episodes of worsening symptoms, leading to significant morbidity and mortality. They are primarily triggered by respiratory viruses and bacteria, causing increased airway and systemic inflammation. Patients with frequent exacerbations have worse health outcomes, including higher hospital admission rates and mortality. Pharmacological interventions such as inhaled steroids, long-acting bronchodilators, and their combinations have shown effectiveness in reducing exacerbation frequency and severity. Non-pharmacological therapies like pulmonary rehabilitation, self-management, and home ventilatory support are also important but require further study. The future of exacerbation prevention lies in optimizing combinations of pharmacological and non-pharmacological therapies to improve health status and reduce hospital admissions and mortality. The article highlights the need for new interventions and well-designed randomized trials to further reduce the burden of COPD exacerbations.