OBJECTIVE Maintenance chemotherapy is a recently approved approach to the treatment of advanced non-small cell lung cancer (NSCLC). We sought to gain insight into patients' perceptions of maintenance chemotherapy using qualitative methods. METHODS We conducted thematic content analysis of focus groups at a freestanding cancer center and at an associated safety-net county hospital. Patients with advanced NSCLC who had started but not yet completed first-line platinum doublet chemotherapy were provided visual and written explanations of maintenance chemotherapy before being guided in group discussion. RESULTS Key themes to emerge for consideration of maintenance chemotherapy included: (1) survival benefits, disease control, and "buying time"; (2) the importance of "doing something"; (3) quality of life concerns; (4) the role of provider opinion/preference; and (5) the importance of logistics. CONCLUSIONS Patients undergoing first-line chemotherapy for advanced NSCLC were able to understand the concept of maintenance chemotherapy, distinguish it from traditional treatment paradigms, identify pros and cons of this approach, and convey reasons for considering it. CONCLUSIONS Advances in oncology care that alter therapy modalities and delivery may significantly impact patient perceptions and treatment experiences. Clinical team members may wish to elicit treatment preferences of first-line patients through clinical discussion that anticipate these considerations.