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Lobectomy remains the standard for early stage lung cancer. In compromised patients, minimally invasive surgical approaches via thoracoscopy allow sublobar resection (wedge resection or segmentectomy) with or without adjunct brachytherapy mesh to offer results that approach that of lobectomy in some cases. Radiofrequency ablation and stereotactic radiosurgery are emerging technologies for the treatment of lung neoplasm, which are particularly applicable in high-risk patients who are not fit for even minimally invasive surgery. Prospective studies are underway in our center and others to further define the role of these new technologies in the treatment of lung neoplasm.