Chest radiography is the basic imaging method in lung cancer. It allows early detection of peripheral and, with lower sensitivity, detection of central neoplasms. The subsequent staging procedure includes other imaging tools, first of all computed tomography (CT) for a noninvasive estimate of the local and regional extent. Because of high sensitivity and lower specificity for mediastinal disease, positive CT scans suggesting inoperability ask for cytological verification whereas negative studies justify surgery unless other contraindications exist. During and after treatment, chest radiography again affords a morphological follow up. Systematic comparison of the current with recent and early post-treatment studies is a prerequisite for detecting tiny signs of recurrent disease and for differentiating them from iatrogenic changes and infection.