Introduction: COPD is the third leading cause of mortality worldwide.Persistent progressive airflow obstruction is a hallmark of the disease.Inhalation therapy improves quality of life and reduces frequency of exacerbations.However, as the disease progresses and peak inspiratory flow rates (PIFR) decrease,there are concerns about the delivery of drugs delivered by dry powder inhalers. Aims and objectives: To determine the prevalence and predictors of suboptimal PIFR in patients with COPD. Methods: Consecutive subjects ?18 years of age undergoing spirometry and diagnosed with COPD at a tertiary care institute over a 6-month period were included.COPD was diagnosed based on a fixed FEV1/FVC ratio <0.7, and classified based on GOLD classification. PIFR less than 60 L/min was considered sub-optimal. Results: 280 participants were included. Median age was 64 years(IQR 52-70).64% were male, 14% current smokers. 73 (27%) were in GOLD stages 3 and 4.Nine subjects (3.4%) had a suboptimal PIFR.Those with suboptimal PIFR had statistically significantly lower peak expiratory flow rate (PEFR)-median 52 L/min,IQR 45-53 compared with those with acceptable PIFR?median PEFR 179 L/min,IQR 128-284.In a multivariate analysis,being a woman,having a higher BMI,and PEFR < 60 L/min were statistically significantly correlated with having a suboptimal PIFR.Severity of COPD was not correlated with suboptimal PIFR. Conclusion: A small proportion of individuals with COPD have a suboptimal PIFR, and this is not correlated with the spirometric severity of the disease.A point-of-care peak flow meter testing could be an easily accessible screening test to detect those who may have a low PIFR, and therefore,might not be suitable for DPI therapy.