OBJECTIVES: Lung cancer is one of the most common cancers in the world. Standard curative therapy includes surgical resection of the primary tumour. Understanding how to combine best clinical outcomes for the most efficient use of resources is important. We undertook a systematic review of the costs related to managing early stage lung cancer to summarize the body of literature from the global community. METHODS: An electronic literature search of EMBASE, MEDLINE and HEALTHSTAR was performed (January 2000-August 1, 2010). The search terms “Lung Cancer” and “Costs and Cost Analysis” or “Economics” were used. Two reviewers independently evaluated articles and consensus was achieved for all discordant evaluations. Data were abstracted using a standardized abstraction form. Costs are reported in 2010 Canadian dollars. RESULTS: The literature search identified 3654 abstracts; 25 articles were included and the research spanned 13 countries. The majority (15/25) of the studies performed cost identification studies; the remainder included 9 cost-effectiveness and 1 cost-utility analyses. Prospective research was performed in only one study. Just over 50% (13/25) of the studies reported a perspective, while 14/25 specified a time horizon for cost and health outcome collection. Overall costs for treating early NSCLC ranged from $24,040 (no recurrence) to $97,774 (persistent recurrence). The mean costs per patient for surgery ranged from $88 (lobectomy chest drain equipment) to $92,967 (thoracotomy lobectomy). CONCLUSIONS: The literature varies in adherence to optimal assessment methodology, and room for improvement is evident. Costs vary by treatment modality, yet few comparisons of available options exist for this population. Further comparisons of population-based clinical and economic outcomes are necessary in order to understand the burden of early lung cancer. This systematic review of the costs of early lung cancer may help to inform the methodologies and costs for future cost-effectiveness evaluations.