The standard care for patients with non-small-cell lung cancer is chemotherapy of supportive care, with surgery being reserved for palliation of symptoms; however, there is a small group of patients with a finite number of extrathoracic metastases (oligometastases) who may experience improved survival by resection of their metastases and the primary site, with or without systemic treatment. This article summarizes the theoretic basis for resection of metastatic lung cancer, reviews the available data addressing management of disease metastatic to the lung, brain, and adrenal glands, and outlines a model for a future clinical trial to investigate the area further.