Objective[|]The aim of this study is to evaluate the mediastinal lymph node (MLN) metastasis comparatively with Tc99m-MIBI SPECT scintigraphy, thoracic computed tomography (CT), and video-mediastinoscopy (VM) in the staging of non-small cell lung cancer (NSCLC).[¤]Materials and Methods[|]Forty consecutive patients (36 men, 4 women, average age 59.3 years) who were to undergo surgical treatment for NSCLC between June 2008 and June 2009 were included in this prospective study. All patients underwent chest 99mTc-MIBI SPECT before VM. SPECT results were evaluated visually and semi-quantitatively. Thoracotomy and MLN dissection were applied in patients who did not have MLN metastasis.[¤]Results[|]The MLN involvement was demonstrated in 6 patients via VM. 99mTc-MIBI SPECT correctly staged 5 out of 6 patients, and CT 2 out of 6 patients. The 99mTc-MIBI SPECT showed better results than CT with regard to positive and negative predictive values and accuracy.[¤]Conclusion[|]This study indicates that Tc99m-MIBI SPECT has a better diagnostic value than CT in detecting MLN metastases in NSCLC.[¤]