Synchronous multiple primary lung cancer (MPLC) is presumed to be an uncommon entity. In the absence of easily available genetic or molecular markers, the differentiation between MPLC and isolated pulmonary metastasis will remain difficult in a clinical setting, leading to controversies regarding management considerations. We present a rare case of synchronous MPLC with differences in (18)^F-FDG avidity on positron emission tomography-computed tomography imaging. We also share our experience with its diagnosis, management, and histopathological results.