ObjectiveTo investigate physicians’ perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD).DesignA cross-sectional online survey was employed between March and September 2022.SettingsSaudi Arabia.Participants1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists.Primary outcome measuresPhysicians’ perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD.ResultsA total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients’ feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p<0.001) and more years of experience (OR: 1.25; 95% CI: 1.08 to 1.45; p=0.002) were associated with the intention to detect depression in COPD patients. The most common barriers linked to recognising depression are poor training (54%), absence of standard procedures (54%) and limited knowledge about depression (53%).ConclusionThe prevalence of identifying and confidently managing depression in patients with COPD is suboptimal, owing to poor training, the absence of a standardised protocol and inadequate knowledge. Psychiatric training should be supported in addition to adopting a systematic approach to detect depression in clinical practice.