Background: Globally, chronic obstructive pulmonary disease (COPD) is a major contributor to morbidity, disability, and mortality. ECGs are frequently abnormal in people with chronic obstructive pulmonary disease (COPD). Findings from electrocardiograms (ECGs) could be useful in making clinical decisions about this disease entity. Aims and objectives: To evaluate the diagnostic values of ECG changes among COPD patients admitted at tertiary care hospital. Methods:Institutional based cross-sectional study was carried out in Dr. DY Patil Medical College and Hospital, Pune, India. A sample of 130 patients with respiratory illness attending OPD under General Medicine were selected randomly during the study period of 2021- 2022.A COPD diagnosis was obtained based on the patient's medical history, chest x-ray findings, and the GOLD criteria based on spirometry. We studied the electrocardiographic profile and its association with severity of the COPD. Results: Out of the total patients, majority were male. The mean age was 53.96±9.43 years. As per GOLD guidelines, 5% had mild, 38% moderate, 35.3% severe and 21.3% had very severe COPD. Most frequent Symptoms was breathlessness (92.7%) on presentation, followed by cough with sputum (79.3%).The most common ECG changes were Ppulmonalewhich indicates pulmonary hypertension (52.2=7%) and right ventricular hypertrophy (42.7%).Other ECG changes were Low voltage of QRS complex(34.7%), R/S ratio V6<1 (19.3%), R/S ratio V1>1 (24%), Right axis deviation of QRS complex (27.3%), Polymorphic P wave(10.7%), cardiac arrhythmias (5.3%) and right bundle branch block (8.7%). All ECG changes were correlated significantly with severity of the disease except Low voltage of QRS complex.