This study assessed preference and ease of use of the Diskus and the Handihaler in symptomatic chronic obstructive pulmonary disease (COPD) patients. No patient had used either device before. Patients were given a questionnaire to assess the inhalers and to rank the most important feature of an inhaler. Patients in Germany (n = 125) and The Netherlands (n = 131) with a mean age of 60 participated. Fifty-eight percent of German patients and 69% of Dutch patients had no problems using the Diskus compared to only 11 and 32%, respectively, using the Handihaler (p < 0.001). Overall, 79% of patients would be happy to use the Diskus and 46% the Handihaler if their physician suggested it. However, 35% of Dutch patients and 72% of German patients stated they would not be happy to use the Handihaler. The Diskus was rated higher than the Handihaler for the top three features of an ideal inhaler. Overall the Diskus inhaler was preferred by 67% of patients.