A 71-year-old man was referred for a chest x-ray of the right upper lobe lung mass in August 2005. Bronchoscopy and transbronchial biopsy revealed squamous cell carcinoma. A routine metastatic workup revealed his clinical stage to be IIIA (cT2N2M0). We treated him with chemotherapy and radiotherapy. However, an abdominal CT scan showed an 8 cm nodule in the spleen in June 2006. Splenic metastasis from lung cancer is rare. Only 13 cases have been reported from 1990 to 2008. Four of 6 cases (67%) who did not have splenectomy reported splenic rupture and had poor outcomes. Therefore, we considered that splenectomy could possibly improve the prognosis of this patient with isolated splenic metastasis. We report a case with a brief review of the literature and summarize the 13 reported cases.