Background: In the western world, 30-40% of very preterm born infants develop bronchopulmonary dysplasia (BPD), a severe and common complication of preterm birth, with a potential long lasting impact on cardiopulmonary health. Objective: To investigate long term pulmonary morbidity in preterm born young adults with and without BPD, compared to at term born young adults. Methods: 20 preterm born young adults BPD ( gestational age (GA), 27 [26-28] weeks) and 20 without BPD (GA age 28 [27-29] weeks (median[IQR])) were prospectively compared to at term born young adults (GA 39 [38-40] weeks). Participants were subjected to spirometry, body plethysmography, cardiopulmonary exercise testing and quality of life status. Results: Forced vital capacity in 1 second (FEV1) was significantly reduced in BPD participants compared to preterm born participants without BPD (mean±SD Z-score: -1.73±0.79 vs. -0.41±0.70, p<0.001) and compared to at term born participants (-0.49±1.00; p<0.001). 70% of the BPD participants showed an airflow obstruction. In cardiopulmonary exercise testing, BPD participants had lower peak oxygen consumption compared to at term born participants (91±18 vs. 106±17% of predicted, p=0.01). A slight decrease in percieved physical functioning was reported in BPD participants compared to at term born participants (95 [83-100] vs 100 [95; 100]). Conclusions: BPD participants show a distinct, obstructive lung pattern without overt daily life complaints compared to preterm born participants without BPD and at term born young adults, and might be at increased risk for chronic obstructive pulmonary disease later in life.