The concept of fractal geometry is useful for the analysis of irregular and complex structures often seen in nature. Here we apply this concept to investigate the structural mechanism of the development of pulmonary emphysema in the klotho mouse, which, after milk feeding, exhibits characteristics resembling aging and develops emphysema. We calculated the relationships between perimeter and size characterizing shape and between cumulative frequency and size of the terminal air spaces identified from histologic slides and found that both relations followed a power law with fractal properties. However, the fractal dimensions related to the shape and size (Dsn) in the klotho mice were significantly lower than in controls. Additionally, in the klotho mice, Dsn decreased with age without significant change in mean linear intercept. These abnormal morphological changes were restored when the klotho mice were fed with a vitamin D-deficient diet. Previously undescribed morphological model simulations showed that a random destruction, in which the destruction process occurs homogeneously in the lungs, was more consistent with the data than a correlated destruction that is usually seen in smoking-related human emphysema. These results suggest that the pathological changes in the lungs of the klotho mice are derived not from localized causes, but from systemic causes that are related to abnormal activation of vitamin D. The morphogenesis of emphysema in the klotho mice and morphological analyses using fractal geometry may contribute to the understanding of the progressive nature and cause of parenchymal destruction in human emphysema.chronic obstructive pulmonary disease ͉ fractal ͉ lung ͉ morphometry ͉ simulation C hronic obstructive pulmonary disease (COPD) is a progressive lung disease that consists of airway obstruction and pulmonary emphysema, which is characterized pathologically by abnormal and permanent enlargement of the air spaces distal to the terminal bronchioles with the destruction of their walls (1). To study the mechanism of progression, several techniques have been proposed to evaluate air space enlargement and parenchymal destruction in various mouse models of emphysema. The enlargement of air spaces has been evaluated by using the mean linear intercept (Lm) technique, described originally by Dunnill (2). The degree of parenchymal destruction is usually determined by a microscopic point counting technique called the Destructive Index (DI) (3). These morphological indexes have proved useful in evaluating the extent and severity of emphysema, one form of COPD, and have been used for understanding of the relationship between pathological and clinical findings (4, 5). However, these indexes are limited because they do not account for the irregularities and structural complexity of the lung periphery, and hence they are unable to quantify how the air spaces become enlarged and destroyed (6-8).Recently, the concept of fractal geometry developed by Mandelbrot (9) was applied to pulmonary physiology and histology...