Paradigm of chemotherapy for elderly patients with advanced non-small cell lung cancer (NSCLC) remains immature. High-level evidence of chemotherapy for geriatric advanced NSCLC, which contributes to the update of guideline for clinical practice worldwide, was reviewed and analyzed. In light of those evidence, it is generally accepted that single agent chemotherapy is recommended and platin-base doublet is an alternative for elderly patients with advanced NSCLC. In the meantime, it was also suggested that elderly patients with advanced NSCLC have heterogeneity and the management of those patients is de facto an issue of how to arrive at further sub-classification by virtue of their clinical features such as performance status, comorbidity, vital organ function, and so on.