Recently, advance care planning (ACP) for patients with advanced chronic obstructive pulmonary disease (COPD) has become highly recommended in Japan. ACP includes code status, but only a limited number of studies have reported on ACP and code status to date. We attempted to evaluate the usefulness of ACP among the 49 patients with advanced COPD in our hospital. ACP was proposed to 24 (49.0%) of these 49 patients; the most frequent timing of the first proposal of an ACP was the second or subsequent acute exacerbation. No proposals preceded the first acute exacerbation. The code status of each patient varied. Reconfirmation of each ACP was flexibly proposed as needed; four (16.7%) of the 24 cases with ACP decided to change their decisions about respiratory management. The treatment policy for each patient was conducted according to the patient's ACP to provide each person's desired end-of-life care. ACPs for patients with advanced COPD are very important tools for achieving a better quality of life by respecting each patient's wishes in deciding treatment policy. We hope that the utilization of ACP spreads throughout Japan.