BACKGROUND-We want to study electrocardiographic changes in chronic obstructive pulmonary disease and its correlation with airflow limitation METHODS- It was a cross-sectional observational prospective study conducted on Patients hospitalized at the Govt General Hospital Dept of General Medicine and in collaboration with Pulmonary Medicine, Kurnool Medical College, Andhra Pradesh, during the period from January 2022 to December 2022 RESULTS- Among 50 cases, 40 males and 10 females were observed between the ages of 51 and 80 years. The average BMI was 21.8 kg/m2. Smoking habits are seen in all males. Females had a history of exposure to bio-combustibles. Among the COPD cases, the majority (40%) were belonging to severe airflow limitation (GOLD C), followed by very severe (32%), moderate (22%), and mild (6%) categories. Most of the patients (40%) were in GOLD stage C, with Right ventricular hypertrophy being the most prevalent ECG abnormalities (52%). The Mean FEV1% in mild is 81.3 +0.57, moderate is 63.9+6.28, the Mean FEV1 in severe is 41.15±4.59, and in Very Severe 25.625±2.41. The overall mean FEV1 % was 43.6±17.48% which was statistically significant (P <0.05). The present study shows 42% of patients had FEV1/FVC ratio between 41-60, as most of the patients belong severe degrees of airflow limitation. The most important risk factor for COPD is smoking, which is present in 80%of COPD patients (mean pack of 20.67±6.5 years). The study showed a majority of the patients had abnormal ECG, in which the most common ECG change was Right ventricular hypertrophy which was present in 52% of cases, followed by RBBB in 40%, Right axis deviation in 34% of patients, P pulmonale in 32%, and Atrial Fibrillation observed in 22%. The severity of the disease was associated with all ECG abnormalities (p<0.05). Upon ECG change, RVH was detected in 1 case of mild category, and 50%, 36.36%, and 68.75% of severe, moderate, and very severe category patients. P. Pulmonale was found in 9.09%, 20%, and 68.7% of moderate, severe, and very severe patients. RAD was found in 9.09%, 50%, and 37.5% of moderate, severe, and very serious patients. Poor R wave progression was noted in 9.09%, 20%, and 56.25% of moderate, severe, and very severe patients. RBBB was seen in 18.18%, 35%, and 68.75%of moderate, severe, and very severe patients, respectively. Patients in the moderate, severe, and very severe categories had 18.18%, 15%, and 37.5%, respectively. ECG results were correlated statistically with the length of symptoms. 'p' pulmonale, right axis deviation, RVH, and RBBB all increased with the duration of the condition. FEV1/FVC values were found to have a negative connection with the occurrence of certain electrocardiographic characteristics. (r=-0.594, -0.710, -0.661, - 0.176, and -0.374 for P-wave axis > +90°, QRSaxis >+90°, P-wave height > 2.5 mm in lead II, R wave in V1 > 7 mm, and RBBB). COPD patients with a poor FEV1/FVC% ratio had more ECG abnormalities..