Purpose <p>Blood hypercoagulability is associated with poor prognosis in elderly patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to explore whether sarcopenia, a common disease among the elderly, could promote the hypercoagulable state in such patients.</p> Methods <p>Elderly patients with stable-phase COPD were divided into the sarcopenia group (<i>n</i> = 192) and the non-sarcopenia group (<i>n</i> = 264). Sarcopenia was diagnosed according to the criteria for risk assessment, muscle mass measurement, muscle strength evaluation, and muscle function assessment. All patients were followed up for 18&#xa0;months, and the acute exacerbation of COPD was recorded. The characteristics of COPD, coagulation function, and potential confounding factors during the stable and acute exacerbation phases were collected. Multivariate logistic or linear regression was used for data analysis.</p> Results <p>Compared with the non-sarcopenia group, the levels of PLT and AT-III in patients of the sarcopenia group were significantly lower, while the levels of PAR, PT, APTT, FIB, and D-dimer were significantly higher during both the stable phase and the acute exacerbation phase of COPD. More importantly, compared with the non-sarcopenia group, the deterioration amplitudes of most coagulation indicators in patients of the sarcopenia group were significantly greater during the process of COPD developing from the stable phase to the acute exacerbation phase.</p> Conclusion <p>There is a significant correlation between sarcopenia and blood hypercoagulability in elderly patients with COPD. Sarcopenia seemingly has the potential to be a risk factor for the blood hypercoagulable state in such patients, but further verification is still needed.</p>