Objective: To investigate the effects of water-based pulmonary rehabilitation program on pulmonary functions, exercise capacity, anxiety and depression level and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). Material and Methods: Fifty moderate or severe COPD patients without respiratory failure were included. They were randomized either to water-based exercise (WE) group (n= 25) or to control group (n= 25). Spirometry and 6-minute walk test (6-MWT) were performed. QoL was assessed by the Chronic Respiratory Disease Questionnaire (CRDQ). Level of anxiety and depression was assessed using the Hospital Anxiety and Depression (HAD) Scale. WE group received 4-week water-based pulmonary rehabilitation program including shoulder girdle and upper extremity strengthening exercises for 35 minutes, three times a week (totally 12 sessions) in addition to medical therapy. Control group received only medical therapy. All the assessments were repeated one month after intervention in both groups. Results: The mean ages of the patients in WE and control groups were statistically not different (respectively 60.9 +/- 8.8, 64.1 +/- 8.9, p= 0.207). All the patients in both groups were males. No significant improvements in pulmonary functions and 6-MWT distance were observed at one month compared to baseline in both groups. We observed statistically significant decrease in anxiety scores and significant increases in dyspnoea, emotional function and patients' feeling of control over the disease scores of CRDQ at one month compared to baseline in WE group. In control group, no significant differences in anxiety and CRDQ scores were observed at one month compared to baseline. Conclusion: Pulmonary rehabilitation is known to be cost-effective in patients with COPD. Water-based exercises are effective in improving QoL and anxiety level in COPD patients, thus it can be supposed as an alternative to land based pulmonary rehabilitation programs.