Background The main determinants for COPD exacerbations are previous history of exacerbation, the severity of the disease, and the presence of comorbidities. However, the role of GER in this setting remains unclear. Aim To assess the impact of GER on COPD severity and exacerbation frequency. Methods Stable COPD patients were included.Diagnosis of GER was done by GERD questionnaire.Patients were classified into two groups (COPD with GERD & COPD without GERD). Associations of GERD with degree of airway obstruction, frequency of exacerbation ,ICU admission and mechanical ventilation in the previous year were assessed. Factors associated with exacerbation were analysed by regression analysis Results The current study included 233 COPD patients and were classified into two groups;Group A: COPD with GERD including 56 patients (24%) and Group B : COPD without GERD including 177 patients (76%).Group A had more ICU admission and mechanical ventilation events in the last year (P= 0.01&0.009 respectively).COPD patients with GERD had more severe degree of airway obstruction measured by FEV1 % (56% versus 62% in COPD patients without GERD.When comparing rate of COPD exacerbation in the last year before inclusion, 60% of COPD patients with GERD gave history of two or more exacerbations while in those without GERD, only 33% were exacerbators. . Current smoking, GERD and Severity of airway obstruction were the three independent predictors of excaerbation in the studied population. Conclusions The frequency of GER in COPD was 24%.COPD with GERD had lower FEV1%, more exacerbation and mechanical ventilation than those without GERD.