Aim: to systematize data on the clinical, diagnostic, and prognostic significance of pulmonary arterial stiffness (PAS) in chronic obstructive pulmonary disease (COPD) and to elucidate its pathogenetic role in pulmonary arterial hypertension (PAH) and right ventricular dysfunction.

Materials and methods. An analysis of scientific research results published from 2015 to 2026 was conducted. Sources for the analysis were selected based on an information search in the PubMed, Google Scholar, Scopus, and Web of Science scientometric databases using the following keywords: “chronic obstructive pulmonary disease”, “pulmonary artery stiffness”, “pulmonary hypertension”, “right ventricular failure”, and “cardiovascular events” (plus Ukrainian equivalents).

Results. It has been found that PAS emerged early in COPD, preceding emphysema or significant airflow obstruction. The progression of PAS correlates with emphysema severity, lung hyperinflation, and bronchial obstruction, predicting disease severity, exacerbation frequency, and cardiovascular mortality. Loss of pulmonary artery compliance drove early right ventricular dysfunction, even with moderate PAH.

Conclusions. PAS in COPD serves as a valuable diagnostic marker of early remodeling within the pulmonary circulation. Assessing PAS parameters offers substantial diagnostic and prognostic value for tailoring patient management.