We report the case of an extremely elderly patient with long-term survival after surgical resection for lung cancer. A 93-year-old man was evaluated for an abnormal density on chest radiography. Chest computed tomography (CT) showed a nodular density of 2.5 × 2.5 cm in the left S4b segment. Lung cancer was diagnosed by bronchoscopy, and left posterolateral thoracotomy and S4 segmentectomy were performed. Group 1 lymph node dissection and sampling of the 6th lymph node were also performed. Pathological examination revealed poorly differentiated squamous cell carcinoma without any lymph node metastases. The tumor was staged as p-T1aN0M0 stage IA. No complications were encountered postoperatively, and the patient was discharged. He remains alive as of 5 years postoperatively without any recurrence.