Chronic obstructive pulmonary disease (COPD) is a serious respiratory disease with high morbidity, disability and mortality rates worldwide. According to the World Health Organization (WHO), COPD is the fifth most common disease leading to death and the 10th most common disease causing a heavy burden on patients. Another study found that the incidence of osteoporosis increases with the progression of COPD (9.6% in patients with GOLD stage III COPD, 17.9% in patients with GOLD stage IV, and up to 59% in patients requiring lung transplantation). In addition to seriously affecting the quality of life of COPD patients, osteoporosis and fractures also have a serious impact on the respiratory function of COPD disease itself. In clinical practice, the skeletal health of COPD patients is a blind spot for clinical attention, and the diagnosis of osteoporosis and fractures in COPD patients remains low at 5.9%. a study by Carter et al [7] found that vertebral fractures were diagnosed in only 2.6% of the 255 COPD outpatients reported on initial examination, while expert re-evaluation revealed the presence of vertebral fractures in COPD patients was as high as 51.7%. Even if vertebral fractures are detected during the examination, the patient awareness rate is less than 1/3. Most respiratory physicians in the clinic only focus on the danger of COPD disease itself, but ignore the comorbidity of osteoporosis, and lack enthusiasm for in-depth discussion and comprehensive management. On the other hand, the majority of patients are suffering from the pain of COPD disease, but also face the huge potential problems brought by osteoporosis. From the perspective of respiratory physicians, we would like to discuss osteoporosis in COPD patients, analyze its hazards, pathogenesis, risk factors and solutions, and call on respiratory physicians to take a holistic approach to comprehensive management.