Bronchoscopic lung volume reduction (BLVR) can be suggested as a good alternative for lung volume reduction surgery, which showed high postoperative mortality rate. BLVR by pneumovalve became to be performed widely in foreign countries and have been imported the first among various BLVR techniques. We analyzed its first clinical applications to Koreans. We analyzed patients with emphysema who undertook BLVR by pneumovalve in Asan Medical Center from July to August 2012. A total of four male Korean patients undertook BLVR. Age range was 56-69. Clinical improvement was evident in two patients (the 1st and 2nd patient). FEV1 increased (0.55 L → 1.12 L and 0.67 L → 1.22 L) and 6 minutes walking test (6MWT) also increased 275 m → 495 m and 50 m → 230 m). The first one had pneumothorax with persistent air leak before BLVR, but air-leak stopped after procedure. Another one (3rd patient) had no clinical improvement and we consider the cause is collatera ventilation. The last one (4th patient) is hard to evaluate until now, because of pneumothorax. Overall, two patients had pneumothorax after procedure (2nd and 4th patient); one (2nd) resolved by O2 inhalation, but thoracotomy was necessary for the other (4th). BLVR by pneumovalve can be a powerful treatment modality in selected patients with emphysema. However, cautious selection of patients is necessary because complication such as pneumothorax can occur and some patients can have no clinical improvement. *If it is possible, we want to present this as oral presentation to show and explain images and video clips.