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Patients with chronic obstructive pulmonary disease (COPD) have a limited exercise capacity. Surprisingly, little is known about their levels of physical activity practice. We assessed the levels and determinants of physical activity practice in severe COPD patients.A cross-sectional systematic sample of 346 COPD patients was recruited during 1 yr in four tertiary hospitals of the Barcelona area of Spain. Patients answered a questionnaire, which included physical activity assessment, and performed spirometric tests and blood gases.Seventy-eight percent of patients walked daily whereas 17% did not practice any physical activity. Median energy expenditure in physical activity was 109 kcal·d−1 (IQR 24–239). The following factors were independently associated with a lower physical activity level in a logistic regression analysis: female sex (OR 2.92, 95% CI 1.11–7.70), older age (1.04, 1.01–1.07 per year), higher socioeconomic status (2.23, 1.24–4.02), diabetes (2.66, 1.40–5.06), lower physical and mental quality of life (0.93, 0.90–0.96 and 0.96, 0.93–0.98, respectively, per unit), and long-term oxygen therapy (2.07, 1.19–3.60). Neither FEV1, previous COPD admissions, body mass index, nor other treatments were related to physical activity practice.In conclusion, one third of severe COPD patients in our study reported a level of physical activity lower than the equivalent to walking less than 15 min·d−1. Apart from sociodemographic variables, comorbidity, health-related quality of life, and long-term oxygen therapy were the only factors independently associated with a low level of physical activity.