Relevance: Chronic obstructive pulmonary disease (COPD) is a highly prevalent systemic disease which has a negative influence on both cardiovascular and autonomic nervous systems (ANS). One of the most important components of pulmonary rehabilitation for COPD is exercise training. Exercise training improves dyspnea, quality of life, medical consumption, neuromuscular coordination and selfconfidence in COPD. The use of exercise training programme for modulating the ANS in patients with COPD has been sparsely reported. However, no systematic review has been conducted to support the use of exercise training for ANS modulation in these patients. Purpose: To assess the evidence for the effectiveness of different exercise training on autonomic function (AF) outcomes in patients with COPD. Methods/analysis: Following the PRISMA-guidelines a systematic search was performed in search engines of PubMed, Web of Science and CINAHL using a combination of predefined keywords regarding COPD/exercise training and rehabilitation/outcomes of AF. Full text reports from research studies assessing any measure of AF before and after an exercise training in patients with COPD were included. The included articles were reviewed on methodological quality, and evidence synthesis was done using the GRADE guidelines. Results: Eleven studies were included and discussed in this review. A total of 406 (279 males) patients with COPD (%FEV1 predicted; 32±11 to 50±19 l) were investigated in the studies. Continuous training mode at vigorous intensity (60% to80%ofVO2 max; 60$ to75%of maximal speed/peak work rate)was used in majority of the included studies. Additionally, the exercise training duration and frequency studies was between 30 and 40 minutes/session and at least three times/week, respectively. The evidence synthesis of reviewed results from studies with high methodological quality per AF outcome provided different levels of evidence. Specifically, significant increment for heart rate variability (HRV) in the time domain analysis and heart rate recovery (HRR) following exercise training programmes was supported by a high level evidence. However, the effectiveness of exercise training in enhancing the baroreceptor sensitivity (BRS) and frequency domain analysis of HRV was supported by a limited evidence and no evidence, respectively. Discussion and conclusions: Based on the reviewed studies, it was concluded that exercise training has limited beneficial effects in the AF modulation of patients with COPD. Future studies with high methodological quality and large sample sizes are still necessary. Impact and implications: Summarizing results of studies investigating the effectiveness of exercise training for important COPD co-morbidities, such as autonomic dysfunction will promote an outcome-targeted approach to COPD rehabilitation.