This article discusses the challenges in the early diagnosis of chronic obstructive pulmonary disease (COPD) in light of the 2024 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report. It analyzes and distinguishes between the concepts such as “early COPD” and “pre-COPD”, noting their differences in meaning from practical early diagnosis. Currently, early diagnosis faces difficulties in identifying high-risk individuals, determining disease onset, and assessing the stability of pulmonary function results. Therefore, the author argues that priority should be given to improving the overall diagnostic rate of COPD, and suggests that standardized pulmonary function screening for high-risk populations, combined with long-term management, represents the most feasible early intervention method at present.