The population is aging both in developing and developed countries. What is clear is that currently over 50% of all patients with non-small cell lung cancer (NSCLC) are 65 years of age or older. When deciding a treatment strategy, the biological rather than the chronological age should be carefully assessed, and treatment should only be modified or withheld for very good reason. This applies equally to surgery, radiation therapy, and chemotherapy. Fortunately, recently published studies have focused on the issue and have provided strong evidence of improved progression-free survival, overall survival, and quality of life in elderly patients with appropriately treated NSCLC.