Chronic obstructive pulmonary disease (COPD) is a debilitating disease and it will become the third leading cause of mortality in the world in 2030.It is characterized by bronchitis associated with chronic inflammation and emphysema caused by the destruction of alveolar septa.Despite a common etiologic agent, tobacco smoke, only 25% of long-time smokers develop COPD suggesting important roles of genetic determinants and gene environment interactions.Persistent inflammation, aberrant expression of proteases, oxidative stress, mucus dysfunction, infectious agents, abnormal innate and adaptive immune responses, autophagy, cellular senescence and aging, and autoimmunityare associated with the pathogenesis of COPD.Clinical presentations of COPD are heterogeneous and varied significantly even for subjects with similar degree of impairment in pulmonary functions.Peripheral biomarkers associated with COPD clinical phenotype, disease severity and development have been reported including fibrinogen, SPD, CCP, desmosine, CCL18, and CRP.Systemic manifestations, including osteoporosis, myopathy, malnutrition, renal abnormality, coronary artery disease, and lung cancer may vary greatly among COPD individuals and largely associated with emphysema.Multiple genes have been associated with lung function in heavy smokers.Genome wide association studies of blood biomarker of COPD were also reported.The recent discoveries of genetics and disease biomarkers of COPD provided insight to itspathogenesis and may lead to new targets of therapy and better clinical managements of this devastating disease.