The landscape of lung cancer treatment is rapidly evolving with the use of genomic testing which helps identify specific mutations or resistance mutations for these heterogenous tumors. Advanced lung cancer has a very poor prognosis but identifying other treatment options based on genomic profiling of the tumor can lead to improved outcomes. Evidence of benefit for genomic testing in lung cancer has now resulted in this test becoming part of national guidelines. There are challenges with genomic testing which need to be understood as well as understanding how to apply test results. These results can help identify treatment options or may serve as predictors to respond to specific therapies. CONCLUSION: In the current era of precision medicine, it is imperative clinicians be familiar with genomic testing and be able to offer it to their cancer patients, specifically those with advanced lung cancer.