Abstract Background An effective alternate option for treating primary and metastatic lung cancers that cannot be operated on is image-guided percutaneous thermal ablation. These methods rely on the heating impact of a percutaneous applicator on surrounding tissue to cause coagulative necrosis of the tumor cells. Aims The current study is to assess the role of CT guided thermal ablation in management of lung tumors. Methods Based on radiological and pathological evaluation, our study involved 40 patients who had CT-guided thermal ablation ("MWA & RFA") treatments at Ain Shams University Hospitals and Misr Radiology Center from February 2020 to February 2022.for 1ry and 2ry lung neoplasms. After thermal ablation there is follow up program at 3, 6 & 12 months post ablation. Results Various lung cancers, including primary and secondary metastatic lung deposits, were prospectively treated using CT-guided RF and MW. In our study, there were 64 lung lesions. 38 lesions were ablated in 25 individuals with MWA with overall success about 84.2%, 26 lesions were ablated in 15 individuals with RFA with overall success about 84.6%, there was no statistical significant differences between MW and RF regarding outcome. Regarding complications there was no intraprocedural death and the overall mortality 60 days post ablation was 0%. No major complication encountered during the procedure. All complications were non significantly more common in the MWA group. The MWA group had much larger lesions and more lesions were hilar or para-hilar in comparison to the RFA group. Conclusion Percutaneous thermal ablation is a safe and effective minimally invasive treatment alternative is selected patients.