In patients affected by malignant tumors, spinal column metastases are frequent. The incidence varies between 30% and 70%. Lung cancer is the second most frequent cancer invading the spine in women, following breast cancer. All patients are under risk of symptomatic spinal cord compression. The prognosis is poor. Indications for surgery are progressive neurologic deficit, intractable pain, and impending vertebral fracture. Treatment is to preserve neurological functions, promote pain relief and provide functional improvement. Five patients, with symptomatic metastatic spinal cord compression at the thoracic level secondary to lung cancer were operated on. Invasion of the spinal column was from neighbouring lung tissue by direct extension or through segmental arteries. The patients were evaluated regarding neurological status, pain and disability scores, tumor type, level, and surgical procedure. Lung cancer is an aggressive tumor. Patients with symptomatic spinal cord compression must be treated aggressively. With current spinal surgical techniques and a coordinated effort, the life expectancy and quality of these patients are extended.