OBJECTIVES: To quantify the five-year incidence (2008-2012) and 2012 prevalence of COPD in The Netherlands by the Global initiative for chronic Obstructive Lung Disease (GOLD) 2013 combined assessment categories. METHODS: Using the General Practitioners Database of the PHARMO Database Network, the five-year incidence (2008-2012) and prevalence at July 1, 2012 of COPD (ICPC code R95) by GOLD 2013 combined assessment categories among individuals ≥40 years of age was assessed. Based on degree of airflow limitation (using post-bronchodilator FEV) and risk of exacerbations (based on medication or as recorded by the GP) patients were classified as low-risk COPD (FEV ≥50% and/or ≤1 exacerbations) or high-risk COPD (FEV <50% and/or ≥2 exacerbations). RESULTS: Using a source population of 813,800 individuals ≥40 years of age the five-year (2008-2012) incidence (95% CI) of COPD among patients ≥40 years of age was 0.50 (0.49-0.50) per 100 person years; this was 0.54 (0.53-0.55) among males and 0.45 (0.44-0.46) among females. The 2012 prevalence of COPD in a source population of 805,112 individuals ≥40 years of age was 3.7 (3.6-3.7) per 100 persons; this was 4.0 (3.9-4.1) among males and 3.4 (3.3-3.4) among females. Mean (± sd) age of incident and prevalent COPD patients was 65 ± 12 and 67 ± 12 years, respectively. The distribution of low-risk COPD and high-risk COPD was 90% versus 10%. For patients treated by their GP this distribution of low-risk and high-risk COPD was similar, while patients treated by a specialist had a distribution of 82% versus 18%. CONCLUSIONS: This study describes the epidemiology of COPD in the Netherlands. Results on the distribution of low-risk and high-risk COPD depend on the population studied and the definitions used. Additional information on symptoms would allow a more detailed classification of patients.