We have summarized much of the known information regarding the pathogenesis of dyspnea in the COPD patient and have reviewed a great many of the therapeutic options that have been investigated. It should be obvious that we are really in the early stages of our understanding about this symptom, and that we know very little about how to decide which treatment options are likely to succeed in any individual. At this time, there is no substitute for a careful assessment of each treatment modality that is instituted using a measurement tool, and the value of a comprehensive assessment as outlined cannot be overemphasized.