Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major global health burden, with acute exacerbations (AECOPD) leading to delayed recovery and higher morbidity despite optimal medical treatment. Aim/Objectives: To evaluate the effect of structured respiratory rehabilitation on dyspnea, cough severity, and exercise toler ance in hospitalized AECOPD patients. Methods: A prospective interventional study was conducted on 30 hospitalized AECOPD patients. Participants were divided into two groups: the experimental group received standard care plus respiratory rehabilitation (education, sputum clearance, pursed lip breathing, upper-limb exercises, and walking training), while the control group received standard care alone. Outcomes as sessed at baseline and after 4 days included dyspnea (mMRC), cough severity (VAS), exercise tolerance (6MWT), and sputum expectoration. Results: The experimental group showed significant improvements in dyspnea (p = 0.0052) and exercise tolerance (p = 0.0344) compared to controls. No significant differences were observed in cough severity or sputum clearance. Within-group analysis indicated greater improvement in dyspnea and functional capacity in the experimental group, while the control group improved only in exercise tolerance. Discussion/Conclusion: Early initiation of structured respiratory rehabilitation during hospitalization enhances recovery in AE COPD by reducing dyspnea and improving functional capacity, highlighting its value as an adjunct to standard medical care.