Background and Purpose: Vertebral compression fracture (VCF) is a common comorbidity of chronic obstructive pulmonary disease (COPD), and the coexistence of COPD and temporomandibular disorder (TMD) has been clinically noted. The purpose of the study was to investigate whether VCF increases the risk of TMD in patients with COPD. Methods: This retrospective, population-based longitudinal cohort study enrolled sex- and age-matched COPD patients with and without VCF (1:3) who were identified from Taiwan's National Health Insurance Research Database from 2000 to 2015. Multivariate Cox regression analysis was performed to determine the risk of TMD in COPD patients with and without VCF. The cumulative risk of TMD between groups was estimated using Kaplan-Meier analysis with 15 years follow up. Results: The COPD with VCF group was more likely to develop TMD (adjusted hazard ratio = 3.011, p < 0.001) than the COPD without VCF group after adjustment for sex, age, variables, and comorbidities. In the subgroup analysis, the COPD with VCF group had a higher risk of TMD than the COPD without VCF group in almost all stratifications. The risk factors for TMD in patients with COPD included VCF, osteoporosis, and winter season. Conclusion: COPD patients with VCF are at a higher risk of developing TMD. Clinical Relevance: According to our results, clinicians taking care of patients with COPD should be aware of the occurrence of TMD as a comorbidity.