Treatment strategies for oligo-recurrence of lung cancer have recently been discussed well. Some studies have reported a favorable prognosis after the definitive local treatment for oligo-recurrent lung cancer. The definitive local treatment, including surgery, may be effective for recurrent lung cancer in selected patients. The time to recurrence and number of recurrence regions should be considered when selecting appropriate candidates for surgery. Thoracic surgeons will likely have more opportunities to perform surgery for recurrent lung cancer in the near future. Surgery for recurrent lung cancer requires a high level of skill owing to the difficulty in dissecting the pulmonary artery because of intrathoracic adhesions and the risk of major bleeding. To perform safe surgery, securing the central portion of the pulmonary artery is necessary. By reaching the pericardial cavity, the central portion of the pulmonary artery can be secured relatively safely.