Small cell lung cancer (SCLC) accounts for 20% of all lung cancers. More than two thirds of patients with SCLC present with clinically evident distant metastases. Patients with limited stage disease are treated with a combination of chemotherapy and chest radiation. Patients with extensive stage disease and good performance status are candidates for combination chemotherapy. Almost all patients relapse after an initial response. This article focuses on the common sense approach to the management of SCLC.