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Background The good local control rate of radiation therapy has been reported due to recent advances in irradiation technology. Carbon ion radiation therapy (CIRT) has been shown to be effective for early lung cancer. We report a case of performing salvage surgery on the local recurrence of lung cancer after CIRT. Case presentation A 79-year-old man was referred to our hospital for treatment of local recurrence of left lung cancer at fifty nine months after CIRT. We performed wedge resection for diagnostic purposes. It was diagnosed as s