Impairments in balance and an increased risk of falling are common in people with COPD. This chapter provides an overview of best practices in balance assessment and fall risk management and implications for pulmonary rehabilitation. It reviews the current available research on balance impairments in individuals with chronic lung disease, including a discussion of the relevant evidence for guiding the choice of balance assessment measure in people with COPD. It also synthesizes the literature on balance training as part of pulmonary rehabilitation and provides examples of effective exercise programmes for this purpose. This chapter provides an overview of best practices in balance assessment and fall risk management and implications for pulmonary rehabilitation. It reviews the current available research on balance impairments in individuals with chronic lung disease, including a discussion of the relevant evidence for guiding the choice of balance assessment measure in people with chronic obstructive pulmonary disease (COPD). The chapter discusses a high-level overview of balance and how it is assessed, an up-to-date synthesis of the evidence documenting balance deficits in chronic lung disease and approaches to balance assessment and training as part of pulmonary rehabilitation. An emerging area of interest is balance impairment during acute exacerbations of COPD. Several studies have suggested that balance impairment worsens following an acute exacerbation of COPD. The mechanisms underlying the balance deficits in COPD are complex and multifactorial and remain an active area of research. Severity of COPD has not been shown to be associated with balance impairment.