Chronic obstructive pulmonary disease (COPD) is a heterogeneous group of slowly progressive diseases characterized by airflow obstruction that interferes with normal breathing. In 2005, approximately one in 20 deaths in the United States had COPD as the underlying cause. Smoking is estimated to be responsible for at least 75% of COPD deaths. Excess health-care expenditures are estimated at nearly $6,000 annually for every COPD patient in the United States. To update national estimates of deaths from COPD for the period 2000--2005 (the most recent years for which data are available), CDC analyzed data from the National Vital Statistics System (NVSS). Results of that analysis indicated that an estimated 126,005 deaths of persons aged >/=25 years occurred in 2005 with COPD as the underlying cause, an increase of 8% from 116,494 deaths in 2000. Age-standardized COPD mortality rates remained fairly stable during the period overall but decreased among men and increased among women. To decrease the number and rate of COPD deaths, public health programs should continue efforts to reduce all personal exposure to 1) tobacco smoke, including passive smoke exposure; 2) occupational dusts and chemicals; and 3) other indoor and outdoor air pollutants linked to COPD. Once COPD is diagnosed, chronic disease management programs should work to prevent further deterioration in lung function and reduce COPD mortality.