We report a rare case of cutaneous metastatic small cell lung carcinoma of the upper lip in a 73-year-old man, which was excised and the defect repaired with a single advancement flap from the cheek. The prognosis of such lesions is poor, and the incidence of other metastases elsewhere is high. The aim of treatment was to give him optimal quality of life for the short time left. The patient died of his primary disease four months later.