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Chronic obstructive pulmonary disease is a major cause of chronic morbidity and mortality in the elderly population worldwide. Around 40% of people with COPD suffer from depression and anxiety which remains mostly not diagnosed and untreated. Hence, this study aimed to examine anxiety, depression, stress and its associated factors among elderly patients with COPD in the respiratory treatment unit of Kandy National Hospital, Sri Lanka. These relationships were evaluated with a demographic questionnaire and the “Depression, Anxiety and Stress Scale-21” (DASS-21). Multiple regression analysis was used to examine the relationships between these variables. The sample consisted of 180 elderly patients with a mean age of 68.69±6.25(Mean±SD). Out of them, 177 (98.4%) were males. The results indicated that the risk factors account for 51.2% of the variance in depression, 64.2% of the variance in anxiety and 11.7% of variance in stress. Of those without a pre-existing diagnosis of anxiety, depression or stress, 26.4% met the criteria for at least moderate depression, 23.9% met the criteria for at least moderate anxiety and 24.2% met the criteria for at least moderate stress. Monthly household income had a negative correlation while number of presenting comorbidities apart from COPD and number of COPD exacerbations in the last year were positively correlated with the construct of depression, anxiety and stress. These findings suggest that screening programmes for other comorbidities and commencing early treatment, encourage patients to participate in follow-up visits and to establish supportive economic strategies for the patients during the economic crisis.