Somma-Vesuvius is well known for its powerful Plinian explosive eruptions, however during the last eruptive cycle (1631–1944), persistent activity took place on the stratovolcano as mild and violent Strombolian, and effusive eruptions, forming more than one hundred lava flow fields. An important mechanism of lava transport within lava flow fields is the formation and development of lava tubes. The presence of lava tubes in a flow field can greatly increase their distance of emplacement. Observations of lava tubes at Vesuvius have been documented in historical records and speleological reports but no modern scientific studies are available. This work focuses on lava tubes formed in the compound lava flow field of the long-lived 1858 eruption (from 27 May 1858 to 12 April 1861) that was fed by seven eruptive fissures. The temporal and spatial evolution of the 1858 lava flow field was reconstructed using historical documentation. The exposed lava flow field surface was analysed using a 1-m resolution lidar Digital Surface Model (DSM). Surveys to fully digitize the interior and the overlying surface of the largest lava tube found in the 1858 lava flow field were conducted using a terrestrial laser scanner, optical cameras, and an Unmanned Aerial Vehicle (UAV). The accurate 3D model obtained was used to precisely quantify the inner dimensions and to better constrain the morphologies of the lava tube. Observed internal features were described and used to gain information on the formation and activity of the lava tube. Our data allowed us to understand that the described lava tube formed as an inflated lava flow inside which lava flowed through during an extended period ultimately draining out completely at the end of the eruption. Understanding how lava flow fields develop and how lava tubes form on Vesuvius is crucial to re-evaluate the last effusive activity of the volcano and its impact on hazard assessment.