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OBJECTIVE: This study aimed to investigate the correlation between respiratory symptoms assessed by the Respiratory Symptoms Questionnaire (RSQ) and pulmonary function test (PFT) results in patients diagnosed with chronic obstructive pulmonary disease (COPD) at a tertiary care hospital. Methods: This analytical, cross-sectional study was conducted at Sree Balaji Medical College and Hospital, Chennai, involving 130 COPD patients presenting with symptoms of breathlessness, chronic cough, and wheeze. Data collection instruments used were: (1) RSQ: The RSQ was utilized to assess respiratory symptoms, including breathlessness, cough, and wheeze, (2) PFT: PFT assessments, including spirometry, were performed to measure lung function impairment objectively. Participants completed the RSQ under supervision, followed by PFT assessments conducted by trained respiratory technologists using standardized procedures. Results: Descriptive statistics were computed for demographic variables and questionnaire scores. Pearson correlation analysis was employed to assess the association between respiratory symptoms measured by RSQ and PFT parameters. The Chi-square analysis determined the overall association between symptom scores and PFT results across the COPD severity groups. Significant correlations were observed between severe COPD and St. George’s Respiratory Questionnaire, moderate COPD and Clinical COPD Questionnaire, and moderate-to-severe COPD and COPD Assessment Test (P < 0.05). Nonsignificant correlations were found between mild COPD and symptom scores (P > 0.05). The Chi-square analysis confirmed a strong association between respiratory symptoms and PFT results (P = 0.04). Conclusion: This study highlights the importance of comprehensive symptom assessment alongside the objective measures of lung function in COPD management. Integrating tools such as RSQ with PFTs enables clinicians to obtain a holistic understanding of patients’ disease status and tailor treatment strategies accordingly.