The aim of the study was to compare the effects of pulmonary rehabilitation (PR) in COPD patients conducted in the “Wieliczka” Salt Mine and on the surface.51 consecutive COPD patients (FEV1/FVC<0.7, reversibility of obstruction<12%), randomly assigned to the PR programme in the Salt Mine (Group I, N = 27) or on the surface (Group II, N = 24). The following parameters were evaluated before the PR programme (P0), after its completion (P1) and after 3 (P2) and 6 months (P3): the functional status of the lungs, the severity of symptoms (CAT), dyspnoea, BMI, lower limb muscle strength, functional efficiency, exercise tolerance, physical activity, health-related quality of life (HRQoL) and the severity of the symptoms of depression. The place of PR had an influence on some short-term effects. In P1, only group I showed a significant: reduction in dyspnoea, an increase of the muscle strength of the lower limbs, flexibility, agility, limitation of sedentary lifestyle, an improvement in HRQoL (symptoms) and a reduction in the severity of depression. Only group II showed a significant: FEV1/FVC reduction, an increase of intense physical activity and HRQoL improvement (impact on life). The PR had no influence on FEV1, SpO2 and BMI. The strength of the lower part of the body and exercise tolerance were still significantly higher in P2 in both groups. In P2, only group I showed a significant: decrease in the severity of symptoms (CAT) and an improvement in HRQoL (symptoms); in P3: an increase in the strength of the upper limb and HRQoL (total) as well as a reduction in the severity of the symptoms of depression.The PR programme conducted in patients with COPD under the conditions of subterraneotherapy offers greater and longer-lasting benefits than the PR programme implemented on the surface.