In spite of recent improvements in both the technical delivery of radiotherapy and systemic therapy in the treatment of non-small cell lung cancer, local recurrence rates after radiotherapy remain a significant challenge. In the setting of local relapse after radiotherapy, treatments such as surgical resection or radiofrequency ablation are often not appropriate owing to disease and patient factors. Re-irradiation may be a potential treatment option. This overview considers the published evidence and potential treatment strategies. •There is a lack of prospective clinical evidence detailing outcomes after re-irradiation in lung cancer.•Current evidence suggests re-irradiation is feasible and seems to be well tolerated in patients with lung cancer.•Re-irradiation can be considered either as salvage or palliative therapy if the likely clinical benefits outweigh the risks.