Lung volume reduction surgery (LVRS) is an established, successful, palliative surgical therapy for carefully selected patients with advanced emphysema. Although the experience with LVRS has grown over the last few years, the selection of patients suitable for LVRS is still a matter of controversy and differs between centers. Based on their own experience, the authors conclude that LVRS can also be recommended to selected symptomatic patients with advanced homogenous emphysema associated with severe hyperinflation, if diffusing capacity is not below 20% of predicted values and if the CT scan does not show aspects of vanished lungs.