- Desertification and climate warming trends pose a global ecological and environmental problem. The city of Be'er Sheva (Southern Israel) is located at the margins of the Sahara-Arabian dust belt and is frequently subjected to dust storm (DS) with high levels of particular matter (PM), making it an ideal location for investigating the health effects. The objective of this study was to investigate the impact of DS on patients with chronic obstructive pulmonary disease (COPD) in an arid urban environment. We obtained health data of patients 18 years or older discharged from Soroka University Medical Center (SUMC) with a primary diagnosis consistent with COPD exacerbation. Data on meteorological parameters and air pollutants were obtained from two monitoring stations in the city of Be'er Sheva. Time series analysis was performed to assess the COPD exacerbation incidence rate ratio (IRR) resulting from dust storm exposures. We found that daily PM10 concentrations were extremely high during dust storm days, and there is a positive association between dust storms and rate of hospitalization for COPD exacerbation: (IRR = 1.16; 95 %CI, 1.08–1.24; p < 0.001). In addition, an increase per interquartile range in PM10 concentrations increases the IRR by 1.03 (95 %CI, 1.01–1.06; p < 0.001). The effect increased with age and was higher in women. Short-term exposure to natural PM10 during dust storms increases the risk for hospital admission for COPD exacerbation. Further studies are needed to understand the impact of individual characteristics on the health effects of outdoor and indoor PM pollution from dust storms.