The objective of this study was to determine the adherence to an online exercise program for patients with moderate to very severe COPD in their home environment. The intervention consisted of three modules: module 1 online exercising; module 2 telemonitoring and module 3 telecommunication. Patients were instructed to use the service for 12 weeks after the normal rehabilitation period ended (aftercare). The study had a single-center exploratory study design. Adherence to module 1 was assessed by adherence to exercise sessions and log in time (duration in minutes) and frequency of training (amount of time a week) was measured for each patient. In addition, adherence to the exercises was measured as the percentage of performed exercises versus prescribed exercises. The adherence to module 2 was measured by logging the day and time the diary has been filled in. The adherence to module 3 was measured by logging the types of telecommunication options used. Satisfaction with the service was measured with a questionnaire, a number from 0 to 10 and whether patients would recommend the service to others. Twenty patients used the online exercise module. The adherence to the three weekly exercise protocol was 61 %. Patients logged in on average 20.3 min (±15) for 3.6 times a week (±2.3). The mean adherence to these exercises was 58 %. The adherence to the monitoring module was 82 %. Seventeen patients (77 %) used module 3 and send on average 9 messages (± 9.8) during the 12 weeks. Patient satisfaction with the service was high. The adherence to the home-based telemedicine service for patients with moderate to very severe COPD was similar to hospital-based maintenance exercise interventions. However, strategies to improve exercise adherence should be investigated.