Background <p>Previous studies indicated an association between single air pollutant and chronic obstructive pulmonary disease (COPD). However, effects of combined air pollution and COPD burden remain unclear. We provided a systematic evaluation of COPD burden attributed to air pollution globally between 1990 and 2021, emphasizing spatial heterogeneity and identifying drivers, with projection through 2030.</p> Methods <p>Data on mortality, disability-adjusted life years and COPD-attributable air pollution were extracted from the Global Burden of Diseases 2021 database. We conducted joinpoint regression to evaluate the temporal trends from 1990 to 2021. Decomposition analysis was performed to assess the contributions of population aging, growth, and epidemiological shifts. Autoregressive integrated moving average models were utilized to project the age-standardized rates through 2030.</p> Results <p>The global age-standardized mortality rates [45.17 vs. 21.52 per 100,000] and disability-adjusted life year rates [924.96 vs. 439.97 per 100,000] of COPD attributable to air pollution decreased significantly from 1990 to 2021, primarily driven by improved household air pollution. In low-middle and low socio-demographic index (SDI) regions, the COPD burden of atmospheric particulate matters and ambient ozone pollution exposure showed increasing trends, while household air pollution-related burden decreased but still dominated. Population aging and growth increased the burden, especially in low and low-middle SDI regions. Projections suggested high-middle SDI and low-SDI regions may experience worsening air pollution-attributable COPD burdens, with persistent regional disparities.</p> Conclusions <p>Despite declining global trends in air pollution-attributed COPD, the persistent high burden exhibits pronounced regional inequalities associated with SDI. Context-specific strategies are imperative to ensure health equity.</p>