Malignant cord compression is a frequent and potentially devastating complication of metastatic lung cancer. Several therapeutic options are a consideration, including surgery, conventionally fractionated radiotherapy, stereotactic high precision radiation and several interventional radiology techniques, and at times combination of these approaches. This session will be case-based, with an opportunity for the audience to indicate how they would manage the case in their institution, and presentations from a multi-disciplinary team of experts in the management of cord compression. At the conclusion of this activity, the learner will be able to do the following: 1. Discuss which patients with malignant cord compression would benefit from surgery. 2. Explain the benefits and potential limitations of conventional and stereotactic radiation for malignant cord compression. 3. Discuss the potential benefits of vertebroplasty in treating spinal metastatic disease.