OBJECTIVES: Describe patient with Chronic Obstructive Pulmonary Disease (COPD) primary care in an area of  Campania, a region in the southwest of Italy. METHODS: A retrospective naturalistic longitudinal study was conducted using information from general practice database with 109 general practitioner (GP) clinical records whit a list of 151,884 subjects registered at the end of December 2008. The database contains patient demographic details, medical records (e.g. diagnoses, test, etc.), drug history and prevention information. Case of COPD were identified on the basis of the ICD-9 code (491, 496). All drugs prescribed were indentified according to the R03 therapeutic pharmacological subgroup (drugs for obstructive airway disease) of the Anatomical-Therapeutic-Chemical-Classification. RESULTS: A total of 4856 (3.2%) patients suffering from COPD were observed. Between 2006 and 2008,  32.5% of patient had at least one spirometry,  10.8% one hemogasanalysis and 9.3% both. In the same period, 45.6% had at least one influenza vaccination, 9.5% one pneumococci vaccination while 25.5% of COPD patients did not received any drug prescription for their disease. A total of 57.7%  of COPD patients received at least one drug for their disease (R03),  24% had a mono-therapy and 76 % a poly-therapy. The most used drugs category in monotherapy were Inhaled corticosteroids (41.4%), β-agonists (24.6%), xanthine derivatives (19.2%), anticholinergics (14.0% ). Among the poly-therapy cohort, there was an high variety of drug categories combination, in particular the most frequent were the pre-constituted formulation itself (19.4%). CONCLUSIONS: This study shows the high variability in the management of COPD in primary care, which does not seem to be always consistent to published guidelines.