Background:COPD is a long-term lung disease that impacts breathing. This is a progressive ailment that usually deteriorates with time. The present study was conducted to assess the relation between red cell distribution width (RDW) with acute exacerbation of chronic obstructive pulmonary disease. Materials & Methods:70 COPD patients of both genderswere divided into 2 groups of 35 each. Group I comprised of AECOPD patients and group II had stable COPD patients. The blood samples were examined and RDW, RBC count, and CBC were estimated. Results: In group I, there were 20 males and 15 females and group II had 16 males and 19 females. In group I and II, RDW was 10%-20% in 16 and 14 and 21%-30% in 19 and 21 respectively. Smokers were 14 and 8, non-smokers were 6 and 7 and ex- smokers were 15 and 20. Symptoms were cough in 24 and 26, chest pain in 27 and 22, breathlessness in 31 and 29, wheezing in 22 and 23 and expectoration in 14 and 13 respectively. mMRC grade1 was seen in 1 and 0, 2 in 3 and 5, 3 in 5 and 23 and 4 in 26 and 7. GOLD stageA was seen in 1 and 2, B in 4 and 3, C in 11 and 17 and D in 19 and 13 patients in group I and II respectively. The difference was significant (P< 0.05). The mean RDW was significantly higher in death(21.5%) as compared to survived patients (16.4%). Conclusion:The average red cell distribution width on the day of illness presentation was significantly higher in AECOPD than in stable COPD. The likelihood of survival was lower for patients with a high red cell distribution width at the time of admission.