Sir,Recent studies investigated on effectiveness of Ipratropium and Salmeterol — Fluticason (SFC) in chronic obstructive pulmonary disease (COPD) patients. Some of these investigations revealed these increased O2 saturation (SaO2) in duration sleep and increased quality of life.[12] Thus, we decided to evaluate and compare the effect of Ipratropium bromide and SFC on SaO2 in patients suffered by COPD.We selected 35 COPDpatients who referred to Firuzgar hospital in 2009. Participants randomized by computer generated, and then participants treated with Ipratropium bromide (40 μg/QID) or SFC (50/250 mg/BD) under crossover randomization. Each participant was followed for two days, and then treatment stopped for two days. After this, each study group received another medication for two days. We measured SaO2 by fingertip pulsoxymeter, in two groups before and after 15, 30, 60, and 180 min inhalation of SFC or Ipratropium bromide. A repeated-measures analysis of variances was performed to compare the ability of each of the medication to increase SaO2 before and after medication. We revealed both of Ipratropium and SFC increased SaO2, but Ipratropium bromide inhalation was more effective than SFC to increasing O2 saturation after 30 min inhalation these drugs. Our findings indicated that both Ipratropium and SFC increased SaO2, but inhaled Ipratropium bromide was more effective than SFC to increase SaO2 but 30 min after inhalation of these drugs.