Small cell lung carcinoma (SCLC) is a highly aggressive form of cancer with neuroendocrine differentiation, accounting for about 15% of all lung cancer cases. Although SCLC is highly sensitive to chemotherapy and radiation therapy at the initial stages of treatment, recurrence is common within a year or two, with poor outcomes for patients. Here, we present a case of a 69-year-old male with a history of significant smoking who complained of cough, fever, and shortness of breath. After undergoing various investigations, which showed a mass in the right lung, the patient was diagnosed with SCLC based on the results of a bronchoscopic biopsy. The patient underwent chemotherapy with platinum and etoposide along with thoracic radiation therapy, which resulted in partial remission. In the following paragraphs, the difficulties in diagnosing SCLC, its histopathological characteristics, advances in its treatment, and its prognostic factors with recent developments in immunotherapy and target therapy will be discussed.