Specific targeted therapies either in combination with a backbone of standard chemotherapy or as a single agent has made it possible to obtain markedly increased response rates and extend survival, sometimes dramatically, along with a favorable therapeutic index and potentially improving the cure rate.Now it is not adequate to know the cell type of lung cancer but the molecular profile of the tumor.Current technology requires more than few cells for these studies and obtaining adequate tissues for diagnosis is paramount and biopsy techniques have evolved to accommodate this requirement.Surgery remains the main treatment for early stage non-small cell lung cancer.Surgical approach however has evolved over the last few years.Minimally invasive surgery has become the standard of care whether it be muscle sparing thoracotomy, video assisted thoracoscopic surgery or robotic surgery.Minimally invasive surgery has significantly reduced post-operative pain, length of chest tube drainage and hospital length of stay.Additionally this technique has allowed it possible to offer the curative resection in patients with limited pulmonary reserves.