The diagnostic of lung cancer mainly relies on thoracic CT scan and bronchoscopic techniques. During the past decade, several improvements of these diagnostic tools have been made available, which aim to decrease the time to diagnosis and to simplify the initial staging approach. The diagnostic of peripheral lung nodules takes advantage of FDG PET-CT imaging as well as of recent per-endoscopic methods of peripheral lung nodule sampling such as electromagnetic navigation and endobronchial ultrasound. Autofluorescence or narrow band imaging bronchoscopy are helpful for the early diagnostic and monitoring of superficial cancers of the proximal bronchial tree. The diagnostic of intra-mediastinal lymph nodes has been simplified by the use of endobronchial ultrasound--transbronchial needle aspiration. In the near future, these techniques should reduce the need for invasive surgical procedures during lung cancer staging.