Purpose: To evaluate the advantages of ultra-high-resolution computed tomography (U-HRCT) scans for the quantitative measurement of emphysematous lesions over conventional HRCT scans. Materials and methods: This study included 32 smokers under routine clinical care who underwent chest CT performed by a U-HRCT scanner. Chronic obstructive pulmonary disease (COPD) was diagnosed in 13 of the 32 participants. Scan data were reconstructed by 2 different protocols: i) U-HRCT mode with a 1024x1024 matrix and 0.25-mm slice thickness and ii) conventional HRCT mode with a 512x512 matrix and 0.5-mm slice thickness. On both types of scans, lesions of emphysema were quantitatively assessed as percentage of low attenuation volume (LAV%, <-950 Hounsfield units). LAV% values determined for scan data from the U-HRCT and conventional HRCT modes were compared by the Wilcoxon matched-pairs signed rank test. The association between LAV% and forced expiratory volume in 1 s per forced vital capacity (FEV1/FVC) was assessed by the Spearman rank correlation test. Results: Mean values for LAV% determined for the U-HRCT and conventional HRCT modes were 8.9 +/- 8.8% and 7.3 +/- 8.4%, respectively (P<0.0001). The correlation coefficients for LAV% and FEV1/FVC on the U-HRCT and conventional HRCT modes were 0.50 and 0.49, respectively (both P<0.01). Conclusion: Compared with conventional HRCT scans, U-HRCT scans reveal emphysematous lesions in greater detail, and provide slightly increased correlation with airflow limitation.