The article discusses mortality prevention as the central focus of COPD management. It highlights that COPD is a major global health issue, with significant mortality risk factors including increased symptoms, reduced lung function, lower DLCO, decreased exercise capacity, and emphysematous phenotype. Patients with frequent exacerbations and comorbidities such as cardiovascular disease and diabetes are at higher risk. Several composite scores have been developed to predict mortality risk in COPD patients. Recent studies on triple therapy (long-acting beta agonists, long-acting muscarinic antagonists, and inhaled corticosteroids) have shown promising results in reducing mortality compared to dual therapies. The review summarizes available data on mortality risk in COPD patients and describes pharmacologic therapies that have shown effectiveness in reducing mortality. Non-pharmacological interventions such as smoking cessation, long-term oxygen therapy, non-invasive mechanical ventilation, lung volume reduction surgery, and pulmonary rehabilitation have also been shown to reduce mortality. Pharmacological interventions, including triple therapy, have shown potential in reducing mortality, although results from large trials such as TORCH, SUMMIT, and UPLIFT have been mixed. The ETHOS trial showed a significant reduction in mortality risk with triple therapy compared to dual therapy. The article emphasizes the importance of identifying COPD patients at high risk of mortality and tailoring treatment accordingly. It also highlights the need for further research to determine the optimal treatment strategies for COPD patients.The article discusses mortality prevention as the central focus of COPD management. It highlights that COPD is a major global health issue, with significant mortality risk factors including increased symptoms, reduced lung function, lower DLCO, decreased exercise capacity, and emphysematous phenotype. Patients with frequent exacerbations and comorbidities such as cardiovascular disease and diabetes are at higher risk. Several composite scores have been developed to predict mortality risk in COPD patients. Recent studies on triple therapy (long-acting beta agonists, long-acting muscarinic antagonists, and inhaled corticosteroids) have shown promising results in reducing mortality compared to dual therapies. The review summarizes available data on mortality risk in COPD patients and describes pharmacologic therapies that have shown effectiveness in reducing mortality. Non-pharmacological interventions such as smoking cessation, long-term oxygen therapy, non-invasive mechanical ventilation, lung volume reduction surgery, and pulmonary rehabilitation have also been shown to reduce mortality. Pharmacological interventions, including triple therapy, have shown potential in reducing mortality, although results from large trials such as TORCH, SUMMIT, and UPLIFT have been mixed. The ETHOS trial showed a significant reduction in mortality risk with triple therapy compared to dual therapy. The article emphasizes the importance of identifying COPD patients at high risk of mortality and tailoring treatment accordingly. It also highlights the need for further research to determine the optimal treatment strategies for COPD patients.