The present article is intended as an introduction to health economic evaluation as well as a review of economic evaluations of positron emission tomography (PET and PET/CT) in the diagnosis and management of non-small cell lung cancer. Furthermore, the transferability of the results of economic evaluations in other countries to the German health care context is assessed. With the help of a literature search 13 full health economic evaluations of staging (12 studies) and follow-up (1 study) of non-small cell lung cancer were identified. The primary health benefit measure was life years gained or quality-adjusted life years gained. All of these evaluations were based on modeling studies. Due to differences in assumptions and methodological heterogeneity, the incremental cost-effectiveness ratios varied widely. Because of the complexity of the diagnostic and therapeutic process, the transferability of international study results to the German situation is limited. The cost-effectiveness of PET for other management decisions in non-small cell lung cancer (e.g. radiotherapy planning) is still to be assessed.