Previous studies have shown that patients with chronic obstructive pulmonary disease (COPD) who undergo surgical revascularization have higher in-hospital mortality rates. Limited data are available on the outcomes of patients with COPD undergoing percutaneous coronary intervention (PCI). Our study evaluated the association between COPD and in-hospital and long-term mortality in patients undergoing PCI. We studied 10,994 patients who underwent PCI from 1997 to 2003 at our institution (1,117 with and 9,877 without COPD). A patient was considered to have COPD if it was listed as a co-morbid condition in our database. The primary end point was all-cause mortality. Cox logistic regression models were used to determine whether COPD was an independent predictor of all-cause mortality after PCI. The mean age of the study population was 64 years, and 70.2% were men. Significantly more patients with COPD died in hospital (2.9% vs 1.2%, p <0.0001). The median follow-up was 33 months; 89.6% of patients without COPD versus 75.6% of patients with COPD (log-rank 280, degree of freedom 1, p <0.0001) were alive at the end of the follow-up. After adjusting for other variables known to increase mortality, COPD was a significant independent predictor of in-hospital death (odds ratio 2.51, 95% confidence interval 1.45 to 4.35, p = 0.001) and long-term mortality (hazard ratio 2.16, 95% confidence interval 1.81 to 2.56, p <0.0001) after PCI. In conclusion, patients with a history of COPD have higher in-hospital and long-term mortality rates than those without COPD after PCI.