During the period 1931-1974, 464 cases of primary lung cancer were diagnosed in Iceland. Only 34 cases were recorded from 1931-1954, but during the next two decades 156 cases and 274 cases were reported, a total of 430 cases which are analyzed in this paper. There is a preponderance of small cell anaplastic carcinoma 33.4% in this series. Epidermoid or squamous cell carcinoma was found in only 24.7% of cases and large cell anaplastic carcinoma in 15.4%. During the period 1955-1974, 143 major surgical procedures were performed for lung cancer in this country, 68 exploratory thoracotomies and 75 resections. Of the resections 58.7% were pneumonectomies. There were 3 surgical deaths in the resected series, for a mortality of 4%. Pneumonectomy carried a mortality of 6.8%, but lobectomies or segmental resections carried no mortality. In the resected series the absolute 5-year survival rate is 29.3%. Patients with epidermoid lesions have the most favorable prognosis. There is a definite correlation between tobacco consumption or cigarette smoking in Iceland and the rising incidence of lung carcinoma.