Family history of cancer has been described among patients with lung neoplasms. Carcinoid tumors, originally thought to be slow growing and nonmetastatic, have not historically been included in these studies. In some instances these tumors have demonstrated aggressive metastatic potential. A medical record review of 86 patients with histopathologically confirmed carcinoid tumors of the lung, treated at the University of Texas M.D. Anderson Cancer Center between 1959 and 1994, was conducted to describe family history of cancer. Family history of cancer was recorded in 74 (86%) of the medical records and 32 (43%) reported first-degree relatives with cancer. Five-year survival for patients with affected relatives was 45% and 73% for patients without affected relatives (p = .23). Among 67 patients without metastatic disease at diagnosis, the risk of distant metastasis by 5 years was 40% among patients with a positive family history of cancer compared to 6% of the patients without affected relatives (p = .03), (rate ratio 5.01). These results suggest that genetic susceptibility may affect the metastatic potential of some carcinoid tumors.