Background: Following curative surgery for non-small cell lung carcinoma (NSCLC), patients remain at risk for recurrence or for development of second primary lung cancer (SPLC). While regular surveillance imaging may detect early stage recurrence or SPLC, its effectiveness has not been established, and current practice guidelines conflict in terms of optimal frequency and modalities of surveillance. The purpose of this study is to evaluate the effectiveness of surveillance following curative surgery for NSCLC in comparison with usual care. Methods: Electronic databases (MEDLINE, Embase, CINAHL, and Cochrane Library) were searched for pertinent studies published between 1990 and 2010. Major search concepts included non-small cell lung carcinoma, surveillance, curative resection, recurrence, and second primary lung cancer. Baseline data and results were pooled. Outcomes examined included rate of detection of recurrence, presence of symptoms at recurrence, and site of recurrence. Results: 18 studies were included in this analysis. No randomized controlled trials were identified. A total of 699 recurrences and 88 second primary lung cancers were detected among 2716 patients. Of these, 53.1% of cases were detected by surveillance protocol. The majority of patients were symptomatic at detection (65.1%). Distant recurrence was more frequent than local recurrence (67% vs. 33%). Only 109 patients (13.9%) were offered a repeat surgery, primarily for SPLC.