Small cell lung cancer (SCLC) accounts for 15% of lung cancers. Nearly all cases of SCLC are attributable to cigarette smoking, and the remaining cases are presumably caused by environmental or genetic factors. Compared with non-small cell lung cancer, SCLC generally has a more rapid doubling time, a higher growth fraction, and earlier development of widespread metastases. SCLC is highly sensitive to initial chemotherapy and radiotherapy, but most patients eventually die from recurrent disease. These guidelines detail the management of SCLC from initial diagnosis and staging through treatment, and include information on supportive and palliative care. Important updates to the 2008 version include refined categories for performance status and the addition of topotecan as an option for patients who experience relapse. © Journal of the National Comprehensive Cancer Network 2008.