Objective To summarize the initial outcome on the treatment of severe pulmonary emphysema by single lung transplantation . Methods Between January 2003 and September 2004, 6 single lung transplantations were conducted consecutively at our hospital. Of the 6 patients with severe pulmonary emphysema, 4 underwent the right single lung transplantation, and 2 the left procedure. All 6 patients were males with a mean age of 54.2 years (range: 51 - 63 years) , and suffered from severe dyspnea (Grade Ⅳ of the Hugh-Jones dyspnea scale) for 5 to 23 years before operation. Preoperative lung function showed an average FEV1 of (0.69?0.36)L[(23.3?12.9)% of the predicted], PaO2 of (62.5?6.5) mm Hg, PaCO2 of (41.4?14.9) mmHg, 6 MMT of(51.5?18) m and a mean pulmonary arterial pressure (PAP) of (30?6) mm Hg. All patients were treated postoperatively with conventional temate immunosuppression regimen.Results All 6 patients remain alive and pulmonary function were very well with post-operation survival of 24, 19, 14, 10, 9, 4 months, respectively. When assessed at 2 months after lung transplantation surgery, all 6 patients showed normal PaO2 values (more than 80 mm Hg) with an average improvement of 37.6 % , and 5 FEVi were improved significantly (165.2%) in 5 patients. The incidence of acute rejection was 1.2 averagely in this group. As to other complications, aspergillosis occurred in 4 cases, severe lung infection in 2, reperfusion pulmonary edema in 1 at 36th hour postoperatively, and upper alimentary canal hemorrhage in 1 on 7th day. Conclusion Single lung transplantation is effective in treating end-stage pulmonary emphysema.