OBJECTIVES:  Cardiovascular disease (CVD) is a common comorbidity in patients with chronic obstructive pulmonary disease (COPD). Different medical links between COPD and CVD and how they affect each other are discussed. Comorbid CVD might, for instance, enhance the risk of COPD exacerbation and result in increased resource utilization and costs. Aim of the study was to describe the effect of CVD on COPD related resource utilization and direct medical costs among patients with COPD. METHODS:  This study is a retrospective, controlled cohort study based on claims data derived from a German statutory health insurance. Patients ≥40 years with COPD and CVD were matched to COPD patients without CVD by means of propensity scores. Sector specific as well as overall annual (360 days) resource utilization and direct medical costs were analyzed. Group differences in frequencies or means were identified using Chi-Square or t-test, respectively. A p< 0.05 was considered statistically significant. RESULTS:  Each group compromised 7,135 patients. Without any difference in COPD related annual outpatient care utilization (4.2 cases vs. 4.3 cases, p=0.445), higher ambulantory average costs (AC) were observed in the CVD group compared to COPD patients without CVD (399€ vs. 361€, p=0.007). COPD related annual utilization of pharmaceuticals was higher in the CVD group (72.3% vs. 70.1%, p=0.003), whereas AC for medications did not differ between groups (360€ vs. 346€, p=0.109). Neither COPD related hospital utilization (4.0% vs. 3.9%, p=0.796), nor AC (156€ vs. 161€, p=0.779) differed between groups. CONCLUSIONS:  Although this study is limited by a relatively short exposure time to CVD and observation period (360 days), comorbid CVD has an effect on COPD related sector specific annual utilization and direct medical costs. This indicates an intensified treatment need of COPD in the presence of CVD and the need for effective co-treatment strategies.