Small cell lung cancer metastasizes widely, but palatine tonsil is an extremely unusual site for metastasis. Idiopathic pulmo-nary fibrosis is associated with increased risk of lung cancer. However, the most common histological findings among patients of lung cancer with idiopathic pulmonary fibrosis are known as non-small cell lung cancer such as adenocarcinoma and squ-amous cell carcinoma. In addition, the majority of them are located in idiopathic pulmonary fibrosis -associated fibrotic pe-ripheral lesions. In this current report, we describe, for the first time, a case of tonsillar metastasis of small cell lung cancer with idiopathic pulmonary fibrosis detected simultaneously in a 77-year-old man.