To date, observational studies on COPD management in primary care are scarce. This study aimed to provide a detailed description of (1) drug therapy, (2) drug adherence, (3) inhalation technique, and (4) health status of COPD patients recruited via community pharmacies. Cross-sectional, observational study in 93 pharmacies (Belgium). Participants (n=555) completed a questionnaire to collect demographic information, smoking history, influenza vaccination, type of COPD medication and side effects. Adherence to controller COPD medication was 1 year-retrospectively analysed through prescription refill rates. Inhalation technique was scored using a checklist. Health status was evaluated with the SGRQ, CCQ and MRC dyspnoea scale. Mean age of the COPD patients was 68.6 yr, 73.7% were men and 37.2% were current smokers. Influenza vaccination status was significantly lower in patients aged <65 yr (65.9%) than in patients aged 65 years or older (86.0%) (p<0.001). Inhaled corticosteroid + long-acting b2-agonist combinations were the most frequently used COPD medications (75.4%). About 48% of patients was underadherent (<80% adherence), 47% was adherent (80–120% adherence) and 5% was overadherent (>120% adherence). Predictors for underadherence with maintenance treatment were age, SGRQ and n° of drugs. Twenty-one % made major inhalation technique errors with the rescue medication, which were all errors in hand-breathing coordination with pMDI's. This observational study on COPD management highlights 4 main aspects which could be improved: (1) drug adherence, (2) inhalation technique with pMDI's, (3) influenza vaccination in COPD patients <65 yr and (4) smoking cessation.