Lung volume reduction surgery (LVRS) improves dyspnoea, pulmonary function, and physical performance in patients with severe pulmonary emphysema. This study investigated the impact of LVRS on health-related quality of life (HRQL) over a 2-yr period following surgery.Thirty-nine consecutive patients were prospectively assessed before LVRS, and followed over 24 months postoperatively. The assessments included pulmonary function, dyspnoea (Medical Research Council (MRC) dyspnoea score), 6-min walking distance (6MWD) and HRQL using the Short Form 36-item questionnaire (SF-36) .Several domains of SF-36 improved considerably over 2 yrs after surgery: Physical Functioning: 39 ¡ 4 (mean ¡ SEM) versus 16 ¡ 2 (pv0.01); Vitality: 51 ¡ 3 versus 32 ¡ 3 (pv0.01); Social Functioning: 72 ¡ 4 versus 51 ¡ 5 (pv0.01). Also, improvements in pulmonary function (forced expiratory volume in one second (FEV1): 27 ¡ 1% predicted, residual volume (RV)/total lung capacity (TLC): 0.65¡0.01), 6 MWD (274¡16 m) and dyspnoea (MRC: 3.9¡01) were sustained for up to 2 yrs after LVRS (FEV1 36¡2% pred, RV/TLC: 0.58¡0.02; 6 MWD: 342¡19 m; MRC: 2.0¡0.2; pv0.05).In patients with severe emphysema, lung volume reduction surgery had positive effects on health-related quality of life and pulmonary function over 2 yrs.