Chronic obstructive pulmonary disease (COPD) is a heterogeneous clinical entity, which is why a functional marker such as forced expiratory volume in 1 s (FEV1) does not appear to be sufficient to adequately characterize the disease. Recently, the term clinical phenotype was proposed in an attempt to identify groups of patients with distinct clinical, prognostic, and perhaps even therapeutic responses. Under these circumstances, one of the possible phenotypes with the greatest clinical relevance in COPD is the “exacerbator,” a phenotype characterized by the presence of two or more exacerbations per year. This phenotype has been shown to have a poor health-related quality of life, faster disease progression, and greater risk of death. This article reviews the importance of this new phenotype, its distinguishing characteristics, its possible etiopathogenic mechanisms, and the need for differential treatment.