Abstract: Objective: To explore the palliative care needs and influencing factors among patients with severe Chronic Obstructive Pulmonary Disease (COPD), and to provide reference for drawing up palliative care interventions among COPD patients. Methods: Totally 108 severe COPD patients were recruited and investigated by Palliative Outcome Scale(POS), Modified Borg Scale, Karnofsky Performance Status (KPS) Scale, and The hospital anxiety and depression scale(HAD) . Results: The palliative care needs score of COPD patients was 14.102±5.403. The palliative care needs was related to breathlessness, functional status, anxiety and depression. Anxiety and depression, pulmonary function classification, and complication were the influencing factors of palliative care needs. Conclusion: The symptom burden of COPD patients was heavy and the patients need palliative care. The palliative care interventions should be delivered as soon as possible to improve the patients' quality of life.