The purpose of this study was to examine the relationships between coping and psychosocial adjustment of Chinese patients with chronic obstructive pulmonary disease (COPD). A convenience sample of 54 hospitalized COPD adult patients participated in the study. All participants had moderate to severe scores in respect of pulmonary functional status and symptoms. The findings indicated that the participants adopted limited coping strategies and had poor psychosocial adjustment to their illness. No significant correlation was found between the total scores for coping and psychosocial adjustment. Both confrontive and optimistic coping scores of the perceived use and helpfulness of the coping scale were negatively correlated with the total adjustment score. Fatigue, older age, worse perception of current health status, and use of confrontive and emotive coping styles were predictors of worse psychosocial adjustment. This study provides a better understanding of the needs and difficulties experienced by Chinese COPD patients and concludes that modification of such factors by health professionals may lead to a better psychosocial adjustment.