Transverse myelopathy resulting from metastasis of primary lung cancer to the spine causes pain, numbness, muscle weakness, extremity palsy, and bladder and rectal disturbances. This reduces the quality of life (QOL) and performance status (PS) of patients. Further, it is often difficult to perform surgery on the spinal cord and to administer chemotherapy and radiotherapy. We experienced 13 cases (10 men; 3 women; mean age, 64 years) of transverse myelopathy, an initial symptom of metastasis of primary lung cancer to the spine, from April 2004 to March 2012. Histologically, 10 cases were identified as adenocarcinoma; 2 as squamous cell carcinoma; and 1, as small-cell carcinoma. Direct decompressive surgery was performed in 8 cases, and the neurological symptoms improved in 6. Ten cases were treated with chemotherapy and 8 with radiotherapy. The median survival time was 232 days (6-428), and 3 patients survived for more than 1 year. The findings suggest that the prognosis in cases of transverse myelopathy is poor; however, adequate therapy, including surgery, might improve the neurological symptoms, QOL, PS, and prognosis.