〔Abstract〕 Objective To explore the decision-making function under clear risk condition in patients with chronic obstructive pulmonary Disease( COPD). Methods Game of dice task( GDT) with clear risk probability was used to test the risk decision-making ability of 34 patients with COPD( COPD group) and 30 healthy control( HC group) matched with their demographic data. At the same time,the background cognitive functions such as verbal fluency test,digit span test were detected. Results Within the Game of Dice Test,the COPD group( 12. 67 ±3. 11) was more likely to choose the risk option( F =-3. 594,P = 0. 001) than the HC group( 8. 09 ± 6. 65).Compared with the COPD group( 23. 30 ± 30. 73),the HC group( 58. 46 ± 34. 14) was more likely to choose the safety option temporarily after losing money,and the difference of negative feedback utilization rate between the two groups was statistically significant( F =-4. 122, P<0. 001). The final total assets of the COPD group(-1 623. 53 ± 4 121. 57) were usually negative,while those of the HC group( 966. 67 ± 2 785. 60) were all profitable,with a statistically significant difference( F =-2. 975,P = 0. 004). Conclusion Cognitive decline was observed in patients with COPD,and significant changes were observed in decision-making ability under clear risk probability,which was associated with negative feedback utilization.