Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory condition. Bronchiectasis frequently coexists with COPD and defines a distinct overlap syndrome associated with worse clinical outcomes.Clinical, biological, radiological, and arterial blood gas data were retrospectively analyzed from hospital records to describe disease progression and outcomes.This case illustrates the severe clinical course of COPD–bronchiectasis overlap syndrome and highlights its prognostic implications.Early identification of bronchiectasis in COPD patients, particularly in primary care, may allow preventive strategies to reduce severe exacerbations and infectious complications.A 50-year-old man with known COPD and radiologically documented bronchiectasis presented with acute dyspnea, purulent sputum, and respiratory failure. Non-invasive ventilation was initiated. Despite treatment, the patient deteriorated rapidly, requiring invasive mechanical ventilation. He developed septic shock of pulmonary origin with refractory hypotension and hyperlactatemia. Broad-spectrum antibiotics and vasopressor support were administered, but the outcome was unfavorable.This case highlights the severity of the COPD–bronchiectasis overlap syndrome and its poor prognosis. The coexistence of bronchiectasis may promote chronic bacterial colonization, persistent airway inflammation, and recurrent infectious exacerbations, leading to rapid clinical deterioration. In this overlap phenotype, acute exacerbations tend to be more severe, less responsive to standard therapies, and associated with higher rates of respiratory failure and septic complications. The presence of bronchiectasis in COPD patients is therefore not a simple radiological finding but a marker of disease severity. Systematic evaluation for bronchiectasis in patients with frequent exacerbations could allow earlier intervention and tailored therapeutic strategies.COPD–bronchiectasis overlap represents a severe and under-recognized phenotype. Improved detection and targeted therapeutic strategies are needed to improve prognosis in this high-risk population.