Small cell lung cancer (SCLC) accounts for about 20% of lung cancer, with high malignancy, short multiplication time, early and extensive metastasis, sensitive to chemotherapy and radiotherapy, high remission rate in primary treatment, but highly susceptible to secondary drug resistance and easy to relapse. The treatment of small cell lung cancer is mainly based on chemotherapy, which can be combined or sequenced with radiotherapy, and surgery is considered for less than 5% of early stage patients limited to the lung parenchyma. The treatment of limited stage small cell lung cancer is based on synchronous radiotherapy or sequential treatment with chemotherapy and radiotherapy, and synchronous radiotherapy is better than sequential treatment, and synchronous radiotherapy should be given as early as possible, and preventive whole brain radiotherapy should be given, and preventive whole brain radiotherapy has significant survival benefits. Extensive stage small cell lung cancer is mainly treated with chemotherapy, and local or metastatic foci are treated at an elective stage. The issue of surgery for small cell lung cancer is still controversial, and the standardized treatment developed at the International Lung Cancer Conference implemented in 2010 focused on the treatment of non-small cell lung cancer, with few changes for non-small cell lung cancer. The current specific treatment plan for small cell lung cancer that I recognize after synthesizing all meetings and talks with various experts is that non-small cell lung cancer is a systemic disease, with chemotherapy being the first priority. If the lesion is limited, small and early (stage I), it can also be removed surgically without relaxing chemotherapy. For those who still have existing masses after chemotherapy and the patient cannot be operated, radiotherapy is optional. In the author’s experience, after each course of chemotherapy, most patients often have good results and cannot find the tumor, even if the lesion is relatively large up to 5 cm, which makes patients believe in the effectiveness of chemotherapy and give up surgery. Recurrence is often systemic and inoperable. The disappearance of the mass after chemotherapy for small cell lung cancer is not a cure, so surgery is only for early lesions, and these early lesions, most of which do not have distant metastases but are sensitive to chemotherapy, are lost as surgical targets when no lesion can be found after chemotherapy.