The purpose of this study was investigate the role of 18F-2deoxyglucose positron emission tomography (FDG-PET) in staging small cell lung cancer (SCLC), its efficacy for the discrimination of limited disease (LD) and extensive disease (ED) stages and its regional sensitivity for different metastatic locations. Twenty-five patients with histologically confirmed SCLC and 42 radiologically-staged tumor sites were retrospectively investigated. The LD sample included 10 patients while the ED included 15 patients. All of the 25 primary tumor sites (100%) were visualized and 41 out of 42 (97.6%) of the metastases could be identified, but FDG-PET was needed for anatomical localization. The efficacy of FDG-PET was studied in the staging of SCLC patients and compared with the initial staging of conventional modality findings. FDG-PET down-staged (from ED to LD) one case and up-staged (from LD to ED) one case of SCLC. In summary, all of the patients with ED were correctly staged by FDG-PET alone. We conclude that FDG-PET is a substantial tool in the staging work-up of SCLC if it is performed initially to allow fast identification of patients with extensive disease stages and thus saves additional radiological or invasive examinations. Our preliminary results support the usefulness of whole body FDG-PET for staging SCLC.