Introduction: Chronic obstructive pulmonary disease (COPD) refers to a variety of lung conditions that are characterized by persistent, frequently progressive airflow obstruction and chronic respiratory symptoms (dyspnoea, cough, sputum production, exacerbation). COPD patients with persistent dyspnoea are at higher risk of exacerbation in which triple drug inhaled therapy is suggested. Earlier patients who used open triple drug therapy needed at least two inhalers more than once daily. The significance of ICS in the treatment paradigm of patients with severe COPD and recurrent exacerbations has lately been called into question. Our study was conducted to compare acute exacerbation and all-cause mortality among patients who used triple drug regimen via single inhaler and multiple inhalers