Carcinomatous meningitis (CM) and spinal cord metastases (SCM) are uncommon, yet fatal complication for patients with non-small cell lung cancer (NSCLC). Gefitinib, developed to inhibit the tyrosine kinase of the epidermal growth factor receptor (EGFR), represents the first new treatment modality for NSCLC to emerge from the last decade. Furthermore, it is an attractive option for lung cancer patients with CNS metastasis because of its mild toxicity profile, but there are not much data on the ability of gefitinib to cross the blood-brain barrier. And also, the response of patients with CM and SCM to gefitinib has rarely been reported on. We report here a good response to gefitinib by a heavily pretreated 59-year-old man with CM and SCM.