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Summary: Eosinophilic chronic obstructive pulmonary disease (COPD) is characterised by a peripheral blood differential eosinophil count of 2% or more. This phenotype is found in roughly 40% of patients with COPD. These patients have an increased frequency of exacerbations, but benefit from inhaled glucocorticoids as part of a triple therapy regime. However, 30–40% of these patients continue to have significant exacerbations, meaning targeted therapy to reduce eosinophil counts could play a role in future therapy. Mepolizumab blocks interleukin-5 and has been associated with a decreased rate of exacerbation in eosinophilic asthma.