Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are among the leading causes of hospital admissions, impaired quality of life, accelerated decline in lung function, and mortality. Exacerbations are commonly precipitated by respiratory infections, environmental pollutants, and poor adherence to maintenance therapy. Understanding their clinical characteristics is essential for improving management and patient outcomes.Objective: To evaluate the clinical characteristics, precipitating factors, laboratory findings, treatment modalities, complications, and outcomes of patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease.Methods: A hospital-based retrospective observational study was conducted among 240 adult patients admitted with AECOPD over an 18-month period. Demographic characteristics, smoking history, clinical presentation, laboratory investigations, radiological findings, treatment received, complications, and clinical outcomes were analyzed using descriptive and inferential statistical methods.Results: The mean age of participants was 65.3 ± 10.8 years, with males accounting for 72.5% of cases. Current or former smoking was documented in 70.4% of patients. Respiratory tract infections (61.7%) were the most common precipitating factor, followed by environmental pollution (18.3%) and medication non-compliance (12.1%). Dyspnea (96.3%), cough (90.8%), increased sputum production (82.1%), and wheezing (78.8%) were the predominant symptoms. ICU admission was required in 19.6% of patients, invasive mechanical ventilation in 10.4%, and in-hospital mortality was 7.9%. Severe airflow limitation, hypercapnia, multilobar pneumonia, and delayed presentation were independent predictors of poor outcomes.Conclusion: Acute COPD exacerbations remain a major cause of hospitalization and mortality. Early recognition, prompt treatment of respiratory infections, smoking cessation, adherence to maintenance therapy, vaccination, and pulmonary rehabilitation are essential for reducing exacerbation frequency and improving patient outcomes.