INTRODUCTION: Pulmonary rehabilitation (PR) improves physical and symptoms in COPD patients. Patients' coping with daily symptoms and may have more influence on important patient-centred outcomes than the lung function. To date, it remains unknown whether and to what extent styles change following PR, and whether coping styles are associated outcomes of a comprehensive PR. METHODS: Coping styles were assessed in patients before and after a PR programme using the Utrecht Coping List Additionally, lung function, St. George's Respiratory Questionnaire Hospital Anxiety and Depression Scale, anxiety (HADS-A) and depression subscales and six-minute walking distance (6MWD) were recorded. RESULTS: level of active confronting coping style increased (p < 0.05), whereas of avoidance (p < 0.05), passive reaction pattern and reassuring styles decreased following PR (both p < 0.001). More than 50% of the changed their level of active confronting, passive reaction pattern or emotions coping style. Coping styles and/or changes in coping styles were related to changes in exercise tolerance, anxiety and depression, not related to changes in health status. Following PR, SGRQ total score, and HADS-D scores decreased (all p < 0.001), while 6MWD increased (p < CONCLUSION: Comprehensive PR results in change in coping styles of COPD Coping styles are related to improvements in exercise tolerance, anxiety depression, but they are not related with changes in health status after Further studies are needed to evaluate the outcome of interventions targeting coping styles.