© 2021 College of Physicians and Surgeons Pakistan. All rights reserved.Objective: To evaluate the association between the degree of emphysema on computed tomography (CT) images and disease severity, in order to predict the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD). Study Design: Cross-sectional, observational study. Place and Duration of Study: University of Health Sciences, Diskapi Training and Research Hospital, Ankara, Turkey between January 2016 and January 2017. The analysis of the medical records of patients was performed in December 2020. Methodology: Clinically diagnosed COPD patients were included in this study. Based on emphysema severity on CT, the patients were classified into three groups as group I (n=59), group II (n=37), and group III (n=20), and emphysema was not present in the remaining 15 patients. The associations between emphysema severity and the GOLD stage, mMRC dyspnea score and exacerbation frequency were analysed with Chi-square test. Results: In 131 patients, the severity and presence of emphysema was found to be significantly associated with smoking history (p=0.034). However, no significant differences were observed between emphysema severity and exacerbation frequency (p=0.512) and mMRC dyspnea scores (p=0.110). The severity of emphysema was related with the GOLD stage (p=0.001). There was also a significant association between BMI and severity of emphysema, with the severe emphysema cases tending to be underweight (p=0.001). Conclusion: CT-emphysema severity can be used to classify COPD to assist in the clinical characterisation of patients. This type of classification is important to determine the underlying pathophysiology and genomic profile of COPD.