Introduction: Although cigarette smoke is the most important risk factor for COPD, never smokers also comprise important proportion of COPD. There is limited knowledge about CT quantitative measurement of emphysema in never smoker COPD. Objectives: To describe the differences of quantitative measurement of emphysema between never smoker and ever smoker COPD. Methods: We included patients with COPD who were older than 45 years. All subjects underwent spirometry and multi-dectector computed tomography examination. The MDCT images were analyzed to determine total emphysema (defined as the percentage of low attenuation areas [LAA%] less than -950 Hounsfield units; %LAA950). Differences between never and ever smokers were examined. Results: A total of 49 COPD patients were inclued; 23 never smokers and with 25 ever smokers The mean %LAA950 was 0.5 (SD, 1.1) and 15.3 (SD, 7.0) in never and ever smoker COPD cases, respectively. %LAA950 was significantly lower in never smokers with COPD compared to ever smokers (p＜0.001). In the multivariate analysis adjusting age, sex and lung volumes, smoking status was the significant factor to determine the severity of emphysema. Conclusions: Never smokers with COPD have less CT emphysema than smokers. This difference in radiographic expression may in part explain the different features of COPD according to smoking status.