Abstract Introduction: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that is characterized by persistent airflow limitation which is usually progressive and associated with enhanced chronic inflammatory response in the airways and lungs to noxious particles or gases. COPD is the fourth most frequent cause of death after ischemic heart disease, cerebrovascular disease and malignancy. COPD is a common cause of mortality and morbidity worldwide. Acute exacerbation of COPD is an acute event characterized by worsening of patient’s symptoms that is beyond normal day to day variation and leads to a change in medication. Exacerbations accelerate the rate of decline of lung function and are associated with significantly higher mortality. Aim: To compare DECAF and BAP-65 SCORE in predicting the outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease. Objective: To apply DECAF and BAP65 scoring systems on patients who present with acute exacerbation of COPD and to study the outcomes and to predict the better prognostic scoring system. Expected Outcome and Benefit of Study: To identify high risk patient earlier with the better scoring system so as to assess the need for early intervention and easier risk stratisfication. Methodology Study Design: Hospital based prospective observational study. Study Centre: ED, Government Stanley Medical College and Hospital. Study Period: July 2021 to September 2022. Study Population: Patients presenting to the emergency department with acute exacerbation of chronic obstructive pulmonary disease. Result: A total of 130 patients were included in the study. The mortality rate was 58.8% (n=130). Mortality rates patients hospitalised with acute exacerbation of Chronic Obstructive Pulmonary Disease with DECAF scores > 3. The sensitivity of DECAF and BAP65 scores for prediction of mechanical ventilation need was 86.21% and 72.41%, respectively, whereas the specificity of was 68.32% and 31.68%, respectively, with 72.31% accuracy in DECAF score and 40.77% accuracy in BAP65 class. A positive significant correlation was found between DECAF score and BAP65 class (r=0.293, p=0.001). Conclusion: In conclusion, a clinical prediction tool must be applicable, reliable, and beneficial. Both scores are practical in the sense that they can be easily calculated by asking simple questions and conducting routine laboratory tests.The BAP65 scoring system inculdes variable that are non invasive and quick to apply on a patient that is presenting to the ED, but it is also seen that its ease of use has not proven it to be a better scoring system in our analysis. In spite of the small sample size, DECAF score excels in predicting the mortality and the need for mechanical ventilation.