【Objective】To explore the effect of pulmonary rehabilitation on patients with severe and extremely severe chronic obstructive pulmonary disease（COPD）. 【Methods】68 patients with chronic obstructive pulmonary disease admitted to Chaozhou people′s hospital from January 2014 to January 2016 were enrolled in the study，including 51 males and 17 females ，aged（64±8） years old. All patients were divided into treatment group（34 cases） and control group（34 cases）by random number. All patients received routine medication and life style guidance，while pulmonary rehabilitation was added to the treatment group. Follow up for 12 months ，and the data of lung function ，6 minute walking test（6MWT），COPD assessment test（CAT）scores and hospital anxiety and depression scale（HADs）scores were collected regularly.【Results】No statistically significant difference was found between the two groups in forced expiratory volume in one second/prediction（FEV1/Pre），FEV1/FVC，6MWT and HADs score after six months′ follow-up（P > 0.05），while the CAT scores of treatment group was superior to the control group（P < 0.05）. No statistically difference was found between the two groups in FEV1/Pre and HADs scores after 12 months′ follow-up（P > 0.05），while FEV1/FVC，6MWT and CAT scores of treatment group were superior to control group（P < 0.05，P < 0.05，P < 0.01，respectively）. The 6MWT and CAT scores of treatment group were superior to pretreatment after 6 months′ follow-up（P < 0.01，P < 0.001）and 12 months′ follow-up（P < 0.001，P < 0.001）.【Conclusion】Pulmonary rehabilitation for patients with severe and extremely severe COPD can effectively improve their symptoms，lung function，quality of life and exercise endurance.