OBJECTIVES: The objective of this cost study was to measure the resource utilisation and the direct costs associated with health care management of patients with chronic obstructive pulmonary disease (COPD) in Slovakia and to provide a basis for cost-effectiveness evaluations.  METHODS: The cross-sectional survey was performed to obtain the information on the management of patients with COPD and to estimate the direct costs of the disease management. The survey  included 4 experts experienced in COPD treatment. The studied population were cohorts of COPD patients evaluated separately according to the stage of the disease (mild, moderate, severe and very severe). The patients were treated with standard therapy, the cost were set for one average patient per 3 months of treatment. The cost data were assessed and actualized due the 1st July 2014. All types of health care used in COPD management were evaluated (hospitalization, outpatient visits, diagnostics, laboratory tests and the management of symptoms, use of bronchodilators). Moderate and severe exacerbations were also evaluated and the costs  were set for one single event.  RESULTS: The total cost of mild COPD was €26.22, moderate COPD €30.26, severe COPD €92.04 and for the very severe COPD €267.64 for 1 patient /3 months. Expenses for bronchodilators also vary between different stages of COPD, for mild COPD it represented €17.44, moderate COPD €109.54, severe COPD €219.58 and for very severe COPD €206.15. Cost of treating exacerbations were set for one event - for moderate exacerbation €67 and for severe exacerbation €1060.27. CONCLUSIONS: In the management of COPD the most expensive are the costs of hospitalization, outpatient care and symptomatic treatment. The most costly is the management of the very severe COPD and severe exacerbation. This survey can be used as the source for cost inputs in pharmacoeconomic studies.