Small-cell lung cancer (SCLC) represents ~15% of all cases of lung cancer and is characterized by a rapid tumour doubling time, early onset disease dissemination and high sensitivity to chemotherapy. We searched MEDLINE and OVID databases for articles in English published from January 1980 to February 2015. Platinum-based chemotherapy, thoracic radiotherapy and prophylactic cranial irradiation are standard of care. Benefit from second-line chemotherapy is limited. The role of platinum/irinotecan chemotherapy in the Western population and the role of maintenance therapies remain to be established. Knowledge of the biology of SCLC has expanded exponentially and many potential therapeutic targets have been identified. The use of circulating tumour cells can help investigating molecular alterations occurring within tumour cells, understanding drug resistance mechanisms and evaluating new treatments.