Background: Globally, one of the main causes of chronic morbidity and mortality is chronic obstructive pulmonary disease. A clinical pathway is an evidence-based interdisciplinary management tool that defines and optimizes the many tasks performed by professionals involved in patient care, improving patient outcomes and elevating staff and patient satisfaction. Aim: Determine the effect of implementing clinical pathway on level of dyspnea and anxiety among elderly patients with chronic obstructive pulmonary disease. Research design: A quasi experimental research design was utilized. Method: Sixty two COPD elderly patients who were attending the Mansoura University Hospital's chest medicine department were included in the purposeful sample. The individuals were split equally into two groups: study group (n=31) who received clinical pathway protocol, and control group (n=31) who received only routine care. Results: Patients in the study group had significantly improved perceived level of dyspnea on discharge than the control group with mean 4.22±1.05 and 6.00±1.36 for the study group and control group respectively. Also, patients in the study group had significantly improved level of anxiety on discharge than the control group with mean 11.38±3.83 and 18.48±5.98 for the study group and control group respectively. Conclusion: Clinical pathway is effective tool in improving chronic obstructive pulmonary disease patients' level of perceived anxiety and dyspnea. Recommendation: Training programs should be implemented for nurses about respiratory care based on the clinical pathway to improve nurses' performance and patients' outcomes.