Lung metastases are common in breast cancer, colon cancer, renal cancer, sarcoma and tumours of the head and neck. The presentation is usually with a lesion on chest X-ray or CT. Solitary lesions require investigation, as single metastases can be difficult to distinguish from a primary lung tumour. Patients with two or more pulmonary nodules can be assumed to have metastases. The approach to treatment depends on the extent of disease in the lung and elsewhere. For solitary lesions, surgery should be considered, with a generous wedge resection, or radiofrequency ablation if available. Radiotherapy and systemic anti-cancer therapies can be used, dependent on the underlying primary cancer diagnosis (Fig. 1).