A 69-year-old woman was diagnosed with limited stage, small cell lung cancer in February 2001. Systemic chemotherapy and radiotherapy were performed resulting in complete remission of the disease. In October 2001, she complained of pain and numbness of her left arm. Magnetic resonance imaging (MRI) of the neck showed an intramedullary enhanced mass at the C4-5 level. Specimen obtained by tumor biopsy showed pathological diagnosis of metastasis from small cell lung cancer. Neurological symptoms improved after radiochemotherapy. Intramedullary metastasis of lung cancer is very rare, and early diagnosis and multidisciplinary treatment may improve quality of life.