We have performed thoracoscopic lung volume reduction surgery (LVRS) for severe chronic pulmonary emphysema irrespective of the patient's age. Between May 1993 and April 2004, 9 patients older than 75 years underwent LVRS at our hospital. Three of the 9 patients substantially improved lung function and quality of life after LVRS. One patient slightly improved them but went back to the preoperative condition 5 years after LVRS. The other 5 patients showed no clinical improvement after LVRS, 3 of the 5 developed CO2 narcosis and failed weaning from the respirator. Although patient's age older than 75 years is not contra-indication for LVRS, careful selection is needed for LVRS in elderly patients.