Small bowel metastasis from lung cancer is rare. We report a 64-year-old woman with lung cancer (squamous cell carcinoma) complicated with multiple site metastasis and treated with chemotherapy. She suffered from low abdominal pain and fever for more than two days. Abdominal computerized tomography revealed a mass lesion at the ileum with nearly total obstruction of the bowel and suspicion of focal abscess formation. Exploratory laparotomy was performed and a small intestine tumor was found at the ileum with tumor necrosis, bowel perforation and abscess formation. Segmental resection of the small intestine with end to end anastomosis and abscess debridement were performed. The pathological report showed poorly differentiated metastatic squamous cell carcinoma. The present report describes this unusual case and reviews the literature regarding the incidence, complications and treatment of small bowel metastasis from lung cancer.