COPD is a chronic, progressive, and not fully reversible disease. It is a leading cause of morbidity and mortality worldwide with estimated 12.36 million Indians aged 30 years and above especially in smokers. Patients with frequent exacerbations experience a faster decline in FEV1 and peak expiratory flow [PEF] rates than patients with infrequent exacerbations. With various drugs available for this, the present study was undertaken to evaluate the effects of oral theophylline, tiotropium bromide DPI and combination of formoterol and budesonide DPI on PEFR in patients with COPD. Materials and methods: 60 patients were randomised into three treatment groups [Group A receiving active oral Theophylline(400 mgs) one tablet HS, Group B receiving Active Tiotropium bromide(18μgms) DPI, Group C receiving active combination DPI Formoterol (6μgms) + Budesonide (200μgms)], for a period of 12 weeks and their baseline PEFR was compared with their post bronchodilator PEFR. The results achieved were theophylline [26.95 L/m] (p < 0.05), Tiotropium [31.87 L/m] (p < 0.005), Formoterol and Budesonide combination [28.55 L/m] (p < 0.05). Interpretation & conclusion: Tiotropium bromide a novel anticholinergic drug shows a promising effect on PEFR of COPD patients in our study. Regular treatment with bronchodilators like, Theophylline, Tiotropium, and combination of Formoterol and Budesonide leads to bronchodilatation and salbutamol causes additional bronchodilatation despite the presence of other long-acting bronchodilators in COPD patients.