Acute exacerbations are major events in the natural history of chronic obstructive pulmonary disease (COPD) and are associated with increased morbidity and mortality. Although pulmonary rehabilitation increases exercise capacity, reduces dyspnea and improves health-related quality of life, the effects on risk of future exacerbations (and by extension, healthcare utilization) are less well documented. Furthermore, there has been a growing evidence base to support provision of pulmonary rehabilitation in the acute phase of COPD, for example, shortly after hospitalization for an acute exacerbation. This article reviews the role of pulmonary rehabilitation in the prevention and treatment of acute exacerbations of COPD.