Introduction: There is limited information about the end-of-life care provided to patients with end-stage chronic obstructive pulmonary disease (COPD) in comparison to patients with lung cancer. Aim and Methods: We compared the end-of-life care provided to patients with COPD versus patients with lung cancer who died in hospital over a 12-month period in our institution. Results: During the study period, 89 patients died due to COPD (n ¼ 34) or lung cancer (n ¼ 55). Compared to patients with lung cancer, patients with COPD received less palliative care services (50% vs 9%, P < .001) and underwent more diagnostic tests and received more life-prolonging measures. Conclusion: Toward the end of their life, patients with COPD received fewer symptom-alleviating treatments and palliative care services.