Muscle atrophy and exertional dyspnoea are common in patients with severe chronic obstructive pulmonary disease (COPD). Neuromuscular electrical stimulation (NMES) is a new type of training for these patients. A number of randomized trials show that NMES has a positive physiological and clinical effect of muscle strength and endurance in patients with advanced COPD and in patients with acute COPD exacerbations. However, this positive effect is not seen in patients with moderate COPD. We suggest that NMES should be integrated in rehabilitation programmes for patients with severe COPD.