Aims: The 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Report recommends a bronchodilator for all group A patients with chronic obstructive pulmonary disease (COPD). However, evidence in support of this recommendation is lacking. Methods: To determine whether regular inhaled treatment in 2017 GOLD group A patients with COPD improves their health outcomes including exacerbations and symptoms, we recruited patients from two Korean prospective cohorts. Eligible COPD patients had a modified Medical Research Council (mMRC) dyspnea score of less than 2, an St. George’s respiratory questionnaire for COPD (SGRQ-C) total score of less than 25, and had no more than one exacerbation and no hospitalizations during the previous year. Results: After propensity score matching, there were 107 patient pairs, with and without regular treatment. The incidence rates of exacerbations in those with and without regular treatment were not significantly different (incidence rate ratio, 1.24; 95% CI, 0.68-2.25). Significant differences in favor of regular treatment were observed at 6 and 12 months for the SGRQ-C total scores (P = 0.031 and P = 0.025, respectively), and at 12 months for the mMRC score (P = 0.014). Regular bronchodilator monotherapy also resulted in significantly better scores on the SGRQ-C (P = 0.007) and mMRC (P = 0.004) compared with no regular treatment at 12 months of follow-up. Conclusions: Regular inhaled treatment in group A patients with COPD did not reduce the exacerbation rate, but did provide symptomatic benefit. Our findings support the 2017 GOLD.