Chronic obstructive pulmonary disease (COPD) is a major global public health concern. In this study, we examined the comparative efficacy of non-pharmacological interventions within East Asian traditional medicine (EATM-NPI) for enhancing pulmonary function and exercise capacity in patients with stable COPD. A thorough search of electronic databases conducted until May 22, 2022, identified studies employing EATM-NPI in such patients. The evaluation focused on the impact adjunctive therapies on pulmonary function (forced expiratory volume in 1s (FEV1)) and exercise capacity (6-min walking distance (6MWD)). The qualitative assessment encompassed 142 studies, with 133 studies included in one of three network meta-analyses. Participants, aged 49 to 76 years, ranged from 9 to 139 per group, predominantly from China (87.7% of studies). Overall study quality was generally low, and reported adverse events were mild. Notably, moxibustion and qigong adjunctive therapies demonstrated significant improvements in FEV1 (L) and FEV1 (%). Additionally, chuna, acupuncture, qigong and moxibustion adjunctive therapies were associated with significant improvements in 6MWD. In conclusion, EATM-NPI adjunctive therapy, when combined with standard pharmacological treatment, exhibited effects on pulmonary function and exercise capacity in patients with COPD. SYSTEMATIC REVIEW REGISTRATION: The protocol was registered with PROSPERO (CRD42023389431), https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023389431.

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