Background: Small cell lung cancer (SCLC) is an aggressive malignancy with a short median survival time. Because of the rapid growth rate there may be an advantage to emergently beginning chemotherapy as soon as SCLC diagnosis is made. Methods:All SCLC patients evaluated at Cooper University Hospital from January 2011 to September 2014 were reviewed. Multiple clinical factors were analyzed including timing between diagnosis and start of chemotherapy.Results: A total of 75 patients were analyzed. On univariate analysis there was a survival detriment to early initiation of chemotherapy. With multivariate analysis the difference in survival disappeared. With logistic regression, the only variable that was related to overall survival was stage (extensive versus limited). We did not find any subset that benefited from early initiation of chemotherapy.Conclusions: Mortality and cumulative survival time were not improved by early initiation of chemotherapy for any patient subset. Only stage at diagnosis was predictive for mortality and cumulative survival. Our data appears to show that urgency in starting chemotherapy has little bearing on survival in patients diagnosed with SCLC. The data suggest that there is no detriment to a non-urgent start time for chemotherapy. status (including potentially compromising the integrity of informed consent), strain hospital systems with the costs of inpatient chemotherapy and delayed discharge, and interfere with proper disease staging.