OBJECTIVES: Chronic obstructive pulmonary disease is a leading cause of morbidity and associated healthcare resource utilisation globally and its burden is expected to increase in the rapidly aging nation of South Korea. The aim of this study is to investigate the burden of health care resource utilisation by COPD patients in S.Korea and the associated direct medical costs. METHODS: This was a retrospective observational study of data from the National Patient Sample (NPS) data from the Health Insurance Review and Assessment Service (HIRA) for the year 2014. COPD Patients over 40 years of age were identified by searching on ICD-10 codes as well as usage of and COPD medication and/or systemic steroid usage within a hospital setting. Resource use for COPD was measured by number and length of hospital stays, number of emergency room and out-patient visits and the associated costs were assessed. Linear regression modelling is used to explore the impact of comorbidities on total health-care costs, adjusting for age, sex and geographic location. RESULTS:  The number of COPD patients in Korea was estimated as 174,331 in this study and is comparable to what was previously reported. 71% of the identified COPD patients were male and the mean age of the subjects was 71 years indicating that COPD is potentially underdiagnosed in Korea. The average annual out-patient visits and average days of hospitalization for a COPD patient were estimated to be 44 and 33 days respectively. COPD adds an additional 573 million USD to direct medical costs for the Korean health care system. In the next stage of our analysis, we will stratify the costs per co-morbidities and other risk factors CONCLUSIONS: In conclusion, this study demonstrated that high resource use and costs were associated with COPD. This is an important first step to enhance health care spending efficiency.