There has been an increased focus on the development of non-invasive biomarkers capable of accurately identifying lung cancer early in its course and characterizing the nature of the cancer. Exhaled breath is a non-traditional source of biomarkers. In the following sections I will outline recent developments in the evaluation and management of lung cancer that highlight the need for biomarker development, then summarize the evidence suggesting the potential of exhaled breath volatile organic compound biomarkers to meet this need. I will focus on advances that have taken place since 2008, when this topic was last addressed in the Journal of Breath Research.