Small cell lung cancer (SCLC), a high-grade neuroendocrine tumor, accounts for approximately 15% of lung cancer incidents. • DNA methylation in SCLC involves in disease progression such as lineagespecific TFs, cell proliferation, anti-apoptosis, drug resistance, immune evasion, and metastasis. • Challenges of applying DNA methylation in clinical diagnosis and treatment can be overcome by new approaches and technologies.