Steady-periodic multiphase Computational Fluid Dynamics (CFD) simulations were conducted to capture cavitation breakdown in a Francis hydroturbine due to largescale vaporous structures. A reduced-scale model and a full-scale prototype were investigated to display differences in vapor content and machine performance caused by lack of Reynolds and Froude similarity. The model scale efficiencies compared favorably (within 3%) to the experimental cavitation tests. The CFD model and prototype displayed distinct qualitative and quantitative differences as σ was reduced. A stage-by-stage analysis was conducted to assess the effect of cavitation on loss distribution throughout the machine. Furthermore, a formal mesh refinement study was conducted on efficiency and volume of vapor, with three mesh levels and Richardson extrapolation, to ensure convergence.