To investigate the expression of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 2 (VEGFR-2/KDR) in lung tissues of emphysema patients.The peripheral lung tissues were obtained from 35 patients undergoing pneumonectomy. They were divided into three groups: emphysema group (n = 16), control group (n = 14) and smoking group (n = 5). The level of VEGF protein in lung homogenates was measured by ELISA. The expression of KDR protein in lung was determined by immunohistochemistry, the expression of VEGF and KDR mRNA was detected by reverse transcription polymerase chain reaction, and the apoptosis in lung tissues was observed by terminal transferase dUTP nick end labeling (TUNEL).The level of VEGF protein of emphysema group [(2.77 +/- 1.0) pg/ml] was significantly decreased when compared with control group [(4.51 +/- 1.68) pg/ml, P 0.05).The decrease of VEGF and KDR and the increase of alveolar septal cell apoptosis may contribute to the pathogenesis of emphysema.