The standard of care for stage I non-small-cell lung carcinoma is generally accepted to be lobectomy. In patients who are deemed not to be candidates for lobectomy, various treatment strategies are available, including observation, sublobar resection, conventional fractionated radiotherapy, stereotactic body radiotherapy and radiofrequency ablation. However, there is no standardized, clearly established therapy to offer patients in this situation. While ongoing prospective trials will allow refinement of these techniques, the role of these treatment modalities warrants further investigation for this setting.