This prospective clinical trial aimed to assess the clinical efficacy and safety of endobronchial valve (EBV) therapy in a Korean population with severe emphysema. The study included 43 consecutive patients with complete fissure and no collateral ventilation. The patients showed significant improvements in forced expiratory volume in 1 second (FEV1), 6-minute walk distance, dyspnea scale, and respiratory questionnaire scores 6 months after EBV therapy. Adverse events were observed in 13 patients, including pneumothorax in 10 cases, with one resulting in death due to tension pneumothorax. The presence of tuberculosis scars did not impact target lobe volume reduction or pneumothorax frequency. The study concluded that EBV therapy was both effective and safe in the Korean patient population, comparable to results reported in Western countries. The analysis method employed in the study has been transferred to AVIEW Fissure Completeness by Coreline Soft. The trial was registered at ClinicalTrials.gov under NCT01869205.