Emphysema is a chronic progressive disease characterized by abnormal terminal bronchioles. Patients in end-stage have limited treatment. Lung volume reduction surgery(LVRS) is to remove the non-functional emphysematous lung tissue with the aim of palliating symptoms in selected patient with severe emphysema. It provides a new therapeutic method for emphysema. When LVRS is widely accepted after 1990s, a large number of institutions carried out the researches on surgical approaches, perioperative mortality, long-term efficacy and complications. Its targeted beneficial patients and surgical safety had been confirmed too. Bronchoscopic lung volume reduction (BLVR) successfully carried out on the basis of the development of LVRS and bronchoscopy. This article reviews the surgical approaches, safety and efficacy of LVRS and BLVR in patients with emphysema.