Lung cancer remains the largest cause of cancer deaths worldwide and the overall 5-yr survival rate is only 15%. This is because the majority of the lung cancers are diagnosed at late stages and the treatment outcome is suboptimal. However, the survival of patients with early stage proximal lung cancer is excellent and with advancements in technology we are currently well equipped to diagnose and stage these lung cancers. Together with the application of local bronchoscopic therapeutic modalities that may potentially cure early stage intraluminal lesions, there is expanding interest in the further exploration of new avenues for early detection, localisation, staging, treatment and close surveillance of these high-risk patients who are suffering from chronic field carcinogenesis. The present article will deal with various issues regarding early detection, staging and treatment of centrally located early stage, mostly squamous type, lung cancer.