Aim-To propose a computerised image analysis based method for measuring, on paper mounted lung sections, the area macroscopically occupied by emphysema. Methods-The study was based on the assessment of 69 lung sections prepared following a modified Gough-Wentworth technique. The results obtained from image analysis, point counting, and panel grading methods were compared, as was the repeatability of image analysis and panel grading. Results-The results from image analysis and from point counting were not significantly different (p=0.609) and significant quadratic regressions (r=0.96, p<0.001) were found between measurements from image analysis and from panel grading, the computerised technique being shown to be the most reproducible. Conclusions-Image analysis is a valuable and reproducible method to measure the area of lung macroscopically involved by emphysema.