Emphysema, a form of chronic obstructive lung disease is a debilitating chronic condition of lung destruction. Occurring at the level of the alveolus (distal to terminal bronchiole) there is destruction of the alveolar wall and subsequent enlargement of the air space without associated fibrosis. Although there are three types, centriacinar(lobular) is the most common. The other two types being paraseptal (thought to represent the basic lesion of bullous lung disease) and panacinar (the most widespread and most severe and is associated with alpha-1-antitrypsin deficiency). Chest x-ray findings include large lung volumes, flattening of the hemidiaphragms, increased retrosternal clear space, increased AP diameter, and distortion of the pulmonary vasculature which usually occur late in the disease. CT is important in the assessment of emphysema since it can asses the severity and distribution of the disease and reliably differentiate types in patients with mild to moderate forms of the disease. Unfortunately treatment for emphysema remains limited to removing the offending substance (often cigarette smoke) and supplemental oxygen.