In most of the cases, small cell lung cancer is diagnosed at the extensive disease stage. Regarding the micrometastatic process, it might be considered as a metastatic disease in almost all cases. Therefore, chemotherapy is the cornerstone of small cell lung cancer therapy. Cisplatin and VP-16-based combinations are recommended. Chemotherapy alone remains the only recommended therapy in extensive disease, whereas radiochemotherapy is the treatment of limited disease. Concomitant or alternate modalities are acceptable standards in this latter setting. Prophylactic cranial irradiation is recommended for complete responders with initially limited disease.