Background: Biomass smoke is a risk factor for the development of airflow obstruction and COPD, especially in developing countries. COPD due to biomass smoke is still not well characterized, and it might be differ in some aspects from COPD caused by cigarette smoking. We aimed to compare the characteristics of COPD patients with biomass smoke exposed and cigarette smoke exposed. Methods: We identified all female outpatients diagnosed with COPD at Seoul St. Mary’s Hospital between Jan 2013 and May 2017. And, from a Korean COPD Subtype Study (KOCOSS) cohort, we selected female patients with cigarette smoke exposed. Clinical characteristics were compared between two groups. Results: 14 female COPD patients with biomass exposure from Seoul St. Mary’s Hospital and 26 female smokers with COPD patients without biomass exposure from KOCOSS cohort were enrolled in this study. The mean cumulative exposure for the biomass group was 65.36 hour-years and cumulative exposure of tobacco for smoke groups was 28.67 pack-years. The post-bronchodilator FEV1 was 70.69%±18.10% predicted in biomass group and 53.52%±15.86% predicted in smoke group (p=0.004). The post-bronchodilator FEV1/FVC ratio was 59.36±9.05 in biomass group and 45.41±10.67 in smoke group (p ＜0.001). There were no significant differences between the two groups with respect to inhaler uses: ICS/LABA; ICS; LABA; LAMA; LABA/LAMA; or Triple therapy. Conclusions: Biomass COPD group and smoke COPD group have different lung functions. Further studies regarding the characteristics of COPD with biomass exposure are required.