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Objective: Describe the symptoms experienced by patients with chronic obstructive pulmonary disease (COPD), compare women and men with regard to their physical and psychologic symptoms, and determine the predictors of fatigue for the group as a whole and for women separately., Design: Correlational, predictive., Participants: One hundred four (48 women/56 men) outpatients with severe COPD and a mean age of 60 years., Measures: Self-report of fatigue using the SF-36 energy/fatigue subscale and a "lack of energy" question. Self-report of dyspnea, general symptoms using the Memorial Symptom Assessment Scale, and psychologic symptoms using the Brief Symptom Inventory. Pulmonary function tests and arterial blood gas levels., Results: Patients reported a moderate level of fatigue (mean of 44 on the SF-36), with no difference in the reports of men and women. When reporting their "lack of energy" during the past week, women reported more fatigue than did men. Other symptoms in descending order of reporting were dyspnea and cough. More women reported "don't look like myself" than did men. Women and men were similar in their psychologic symptoms except anxiety, which was higher in women (t = 2.64, p < .01). Predictors of fatigue (SF-36 subscale) for the group as a whole were found to be dyspnea and physical symptoms, predicting 42% of the variance. For the women alone, dyspnea and physical symptoms entered the equation, to predict 67% of the variance in fatigue., Conclusions: Predictors of fatigue were similar for women compared to the group as a whole, with symptoms having more of an impact on fatigue than did physiologic variables.