This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage breathlessness — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 70-year-old woman with a long history of hypertension, moderate chronic obstructive airways disease and generalized osteoarthritis. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. The patient reports that over the past few months, she has found it more difficult to walk on level ground, having to stop for a breath after a few minutes, has been coughing more frequently and has had three chest infections in the past year. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.