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Aim: Estimate the incidence of bone metastases (BM) and skeletal-related events according to the histological subtype of lung cancer and its impact on patient survival. Patients & methods: Retrospective cohort study was carried out with patients diagnosed with lung cancer. Cumulative incidence, Kaplan–Meier survival analysis and the risk of death were estimated. Results: In non-small-cell lung cancer (NSCLC), the cumulative incidence of BM during follow-up was 23.8% at 24 months; in small-cell lung cancer, it was 18.5%. The presence of BM in patients with NSCLC was associated with an increased risk of death (hazard ratio: 1.25; 95% CI: 1.04–1.49; p = 0.013). Conclusion: This study revealed a high incidence of BM and skeletal-related events. BM was associated with a poor prognosis in NSCLC patients.