Supportive therapy in COPD includes long-term oxygen therapy (LTOT) and patient support groups as two cornerstones in a comprehensive program of care known as pulmonary rehabilitation. The rich history of LTOT dating to the early 1960s and bolstered by excellent controlled clinical trials of the 1970s, along with additional advances, provided an effective therapy which improved both the quality and length of life in patients with COPD. Many patients with oxygen gain insight into coping with advanced COPD through patient support groups. The need for more cosmetically pleasing oxygen delivery systems to the nose, and future directions in providing oxygen in the home, remain challenges.