OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is associated with elevated levels of pulmonary and systemic inflammatory markers which may lead to high prevalence of inflammation-related conditions. This study examines the prevalence and demographic predictors of inflammation-related multimorbidity among Medicaid beneficiaries with COPD.  METHODS: Observational retrospective cohort study using multiple years (2005-2006) of data from Medicaid Analytic eXtract (MAX) files of California (CA), Illinois (IL), New York (NY) and Texas (TX). Individuals with COPD (n = 37,151) were identified using ICD-9-CM codes for chronic bronchitis (491.xx), emphysema (492.xx), or unspecified chronic airway obstruction (496.xx). Inflammation-related multimorbidity included: cardio-vascular disease, depression, diabetes mellitus, hypertension, hyperlipidemia and musculoskeletal disorders. This variable was categorized into: (i) both physical/mental illness (IF_PHY/MI); (ii) physical illness only (IF_PHY/no MI); (iii) mental illness only (IF_no PHY/ MI); (iv) NONE. Unadjusted group differences were tested using the chi-square statistics. Multinomial logistic regression was used to analyze the association between demographic predictors and inflammation-related multimorbidity. All analyses were conducted using SAS. RESULTS: Overall, 78.9% of study population had an inflammation-related multimorbidity, of which 22.9% had IF_PHY/MI. Musculoskeletal disorders were the most prevalent inflammation-related condition. Multinomial logistic regression revealed that women compared to men (AOR: 1.88; 95% CI:1.75, 2.01); older adults (55-64 years) compared to younger adults (18-24 years) had significantly higher likelihood (AOR: 6.14; 95% CI:5.05, 7.04) of having IF_PHY/MI. Interestingly, African Americans, Hispanics and Asians had lower likelihood of having IF_PHY/MI compared to Whites.  CONCLUSIONS: High prevalence of inflammation-related multimorbidity among individuals with COPD warrant the need for clinical practice guidelines for evidence-based management.