Local recurrence after definitive chemotherapy and/or radiotherapy with curative intent is frequently experienced in patients with locally advanced lung cancer. We evaluated the frequency, feasibility, and efficacy of salvage pulmonary resection after definitive chemotherapy and/or radiotherapy. We analyzed the characteristics and medical courses of consecutive patients who had undergone salvage pulmonary resection after local relapse or progression after chemotherapy, chemoradiotherapy and radiotherapy including stereotactic body radiation therapy (SBRT) and proton beam therapy (PBT). In this analysis, local relapse or progression were defined as increase in remaining tumor size or detection of new lesions by CT and/or FDG/PET-CT. Indications of resectability was assessed by multidisciplinary tumor board. Between January 2000 and January 2018, 46 patients (0.63%) received salvage surgery out of 7,290 patients underwent surgery for primary lung cancer at National Cancer Center Hospital, Tokyo, Japan. Median follow-up time was 24.5 months (range, 2-157.6). Of 46 patients evaluated, 30 (65.2%) were men, the median age was 64.5 years (range, 20-78 years), 22 (47.8%) underwent chemotherapy, 18 (39.1%) underwent resection after definitive chemoradiotherapy, 3 (6.5%) underwent resection after SBRT and 3 (6.5%) underwent resection after PBT. The number of patients undergoing salvage surgery has increased in recent years: 9 patients were between 2000 and 2009, whereas 37 patients were between 2010 and 2018. Method of surgical resection was as follows: 28 lobectomies (2 bilobectomy, 15 right upper, 1 right middle, 6 right lower, 2 left upper, 2 left lower), 10 pneumonectomies (left:right=7:3). One patient received a wedge resection, and one recieved wedge resection with chest well resection, and 2 segmentectomy and lymphadectomy for residual lymph nodes respectively. A complete resection (R0) was achieved in 42 cases (91.3%). Postoperative complications were observed in 3 patients (6.5%): prolonged air leakage, bronchopleural fistula, and atrial fibrillation. There were no post-operative deaths within 30 days after surgery. The five-year progression free and overall survival rate after surgical resection was 39.1% (95% CI.: 19.9-57.9) and 64.1% (95% CI.: 39.3-80.9), respectively. The frequency of salvage surgery after initial treatment has been increasing possibly due to a better treatment course using novel medical and radiation oncology technique. Salvage pulmonary resections demonstrated acceptable morbidity and mortality with promising long-term efficacy in selected patients.