Cellular adhesion molecules might be good markers in some types of malignant tumors and provide useful information in diagnosis and prognosis. The objective of this study was to determine the clinical significance of the serum levels of vascular cell adhesion molecule-1 (VCAM-1) in lung cancer patients treated with platinum-based chemotherapy. One hundred and thirty lung cancer patients were enrolled into this study. Serum VCAM-1 levels were determined by the solid-phase sandwich ELISA method. Age- and sex-matched 34 healthy controls were included in the analysis. Median age was 58 years old, range 35 to 80 years. The majority of the patients had non-small cell lung cancer (NSCLC) (83.8 %) and stage IV disease (60.8 %). The patients' baseline serum VCAM-1 levels were significantly higher than those in the healthy control group (p = 0.02). Male patients had higher serum VCAM-1 level compared with female patients (p = 0.04). The stage of disease and tumor histology were not correlated with serum VCAM-1 assay (p > 0.05). Elevated serum VCAM-1 levels were associated with chemotherapy unresponsive patients compared with responsive patients (p = 0.02). The patients with elevated serum VCAM-1 levels had lower survival rates than the ones with lower levels (1-year survival rate 57.6 vs 69.7 %, respectively, p = 0.04). In conclusion, serum VCAM-1 concentrations may have diagnostic, predictive, and prognostic role in lung cancer patients treated with platinum-based chemotherapy.