Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by airflow limitation and exercise intolerance. Pulmonary rehabilitation, including structured exercise programs, is a key intervention to improve functional capacity and quality of life. However, the efficacy of exercise interventions in COPD patients requires further investigation.Objectives: To evaluate the impact of structured exercise interventions on exercise tolerance, dyspnea severity, and overall quality of life in COPD patients.Methods: A randomized controlled trial (RCT) was conducted with 100 COPD patients (GOLD stages II-IV). Participants were assigned to either a structured exercise intervention group (aerobic and resistance training) or a control group (standard care) for 12 weeks. Outcome measures included pulmonary function (FEV1, FVC), six-minute walk distance (6MWD), quadriceps strength, dyspnea severity (mMRC scale), and St. George’s Respiratory Questionnaire (SGRQ) scores. Adherence rates and adverse events were also monitored.Results: This study showed significant improvements in exercise capacity, with a 15.6% increase in six-minute walk distance (p < 0.001). Quadriceps strength increased by 21.1% (p < 0.001), demonstrating the benefits of resistance training. Dyspnea severity decreased by 30% (p < 0.001), indicating improved breathing efficiency. Pulmonary function (FEV1) remained unchanged (p = 0.12), consistent with prior studies. Quality of life improved significantly, with a 22.6% reduction in St. George’s Respiratory Questionnaire scores (p < 0.001). Adherence was high at 82%, with mild adverse events (15%) and minimal severe exacerbations (2%), confirming the safety and feasibility of structured exercise programs for COPD patients.Conclusion: Structured exercise interventions significantly enhance exercise capacity, dyspnea severity, and quality of life in COPD patients. While pulmonary function remains stable, functional improvements reinforce the necessity of pulmonary rehabilitation in COPD management. Future research should explore strategies to enhance adherence and optimize long-term rehabilitation programs.