This study aimed to explore the value of long non-coding RNA nuclear enriched abundant transcript 1 (lnc-NEAT1) in predicting chronic obstructive pulmonary disease (COPD) susceptibility and acute exacerbation risk, and to investigate the correlation of lnc-NEAT1 with disease severity, inflammation level, and miR-193a in COPD patients. 90 AECOPD patients, 90 stable COPD patients and 90 healthy controls were consecutively recruited. Severity of airflow obstruction in COPD patients was defined by GOLD guidelines. Plasma samples were collected from all participants, then lnc-NEAT1 and miR-193a expressions were measured by qPCR, and TNF-alpha, IL-1 beta, IL-6, and IL-17 were measured by ELISA. Lnc-NEAT1 expression was elevated in AECOPD patients and stable COPD patients compared to healthy controls, as well as in AECOPD patients compared to stable COPD patients; moreover, ROC curves showed that lnc-NEAT1 predicted increased COPD susceptibility and acute exacerbation risk of COPD. Also, lnc-NEAT1 expression positively correlated with GOLD stage and levels of TNF-alpha, IL-1 beta, IL-6 and IL-17 in both AECOPD and stable COPD patients. Furthermore, lnc-NEAT1 expression negatively correlated with miR-193a expression, and miR-193a could predict decreased COPD susceptibility and acute exacerbation risk, and negatively correlated with GOLD stage and levels of TNF-alpha, IL-1 beta, IL-6 and IL-17 in both AECOPD and stable COPD patients. lnc-NEAT1 predicts elevated COPD susceptibility and increased acute exacerbation risk, and positively correlates with disease severity as well as inflammation, but negatively associates with miR-193a in COPD patients.