Ten cases of lung cancer with brain metastasis who received simultaneous surgery for the primary lung tumor and for the metastatic intracranial tumor between 1990 and 1994 are reported. There was no death due to operation, nor were serious complications. With follow up until Feb. 1995, four patients died and its mean survival period was 8.25 months. Six patients are still alive with a mean survival period of 16 months, the longest one being nearly 3 years. The authors hold that, if the primary tumor is located at the periphery of the lung, the brain metastasis is solitary and patient's general condition is good, simultaneous thoraco-cranial operation is indicated and feasible. Postoperative adjuvant chemotherapy is needed to achieve better treatment results.