To improve the treatment of patients with bone metastasis from lung cancer, 178 (23.8%) of 748 patients with primary lung cancer admitted to our hospital during an 11-year period were studied. The 178 patients were mainly women. The frequency of bone metastasis was significantly higher among patients with adenocarcinoma than among those with small cell or squamous cell cancer. The concentration of carcinoembryonic antigen in serum was significantly higher in patients with bone metastasis than in those with stage IV lung cancer without bone metastasis. The bone lesions were symptomatic in 116 patients (65%) and were treated in 67. Symptomatic improvement was achieved in 50 patients (74%) and pain was alleviated in 94%. However, neurological disorders improved in only 41%. Differences in survival did not depend on the presence or absence of symptomatic bone metastasis or no whether the metastases were treated. The median survival time of patients who responded to treatment tended to be longer than that of patients in whom treatment was not effective. The median survival time calculated from the start of treatment was 5 months for patients with bone metastasis and 7.3 months for patients with stage IV disease without bone metastasis. Aggressive local treatment may be effective for painful bone metastasis.