Lung cancer in young adults has been differently described in publications from various regions of the world, in respect of relative incidence, distribution of morphology and stages, and prognosis of the disease. We analysed retrospectively the data from the cancer registry of the Lungenklinik Heckeshorn in Berlin between 1986 and 1995 with regard to this topic. 106/4939 patients were 40 years old or younger (2.1%). The proportion of female patients was higher in the younger group (42 vs. 29%). Adenocarcinoma was the leading subtype in young patients (33 vs. 24%). The younger group showed a higher proportion of inoperable stages IIIB and IV for non-small cell lung cancer (71 vs. 46%). Younger patients with operable stages I to IIIA non-small cell lung cancer underwent surgery much more often than patients older than 40 years (90 vs. 49%), but for all patients with this morphology there was no difference in survival between younger and older patients (302 vs. 314 patients). We conclude that lung cancer presents a clearly different clinical picture in younger patients but not a better prognosis.