Small cell lung cancer (SCLC) accounts for approximately 20% of all cases of lung cancer. It tends to disseminate earlier in the course of its natural history than non-small cell lung cancer and is clinically more aggressive. Approximately 10% of patients present with brain metastases at the time of initial diagnosis, and an additional 40% to 50% will develop brain metastases some time during the course of their disease. The prognosis of patients with brain metastases from SCLC is poor despite years of research. The standard of care remains appropriate medical management followed by whole brain radiation therapy. Current research is evaluating novel agents in an attempt to improve the survival and quality of life in these patients. However, the most effective treatment for brain metastases from SCLC is the prevention of the development of clinically detectable disease. For patients with a complete response to initial treatment, prophylactic cranial irradiation is an effective method of prevention.