Metastatic lung cancer to the small bowel is a rare occurrence. Acute complications such as perforation, hemorrhage and obstruction are even rarer. We present 3 cases of small bowel perforation from metastatic lung cancer. All 3 patients underwent emergency laparotomy. In 2 of them there was no obvious macroscopic appearance of metastatic disease either at the site of perforation or in any other area of the abdomen, whereas in the third patient there were hepatic metastases. The postoperative period was uneventful in all three cases. The longest survival was four months. Our cases bring the number of cases reported in the international literature to a total of 43.