Lung cancer (LC) has an increasing incidence and mortality rate in both sexes in Romania. Due to its gravity, early detection of LC (stages 0, I, II) is very important. We analyzed a group of 161 patients with LC. Early LC was present in 22% (36 patients). More than half of them were in stage II. All patients had high risk for LC: smokers, man, and age over 50. Suggestive symptomatology of early LC included: cough and its change of pattern, hemoptysis and loss of weight. In 95% of these patients radiological abnormalities were already present. Bronchoscopy (including biopsy brushing, bronchial aspiration and bronchial washing) was the main diagnostic procedure for central type LC, but was also useful in peripheral type. Sputum analysis was positive in 92% of cases. Early detection of LC needs an active diagnosis in all patients with high risk, with all available diagnostic procedures (including high resolution computed tomography).