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Background and objective The use of alimta is very little in the treatment of lung cancer. The aim of this work is to study the clinical effect and toxicity of alimta monotherapy in the treatment of advanced non-small cell lung cancer (NSCLC). Methods 23 patients with advanced diagnosed by pathology or cytology were enrolled into the study. The patients received alimta 500 mg/m2 on d1, intravenously every 3 weeks and were evaluated effect after 2 cycles. Results 67 cycles of the chemotherapy were completed and the median cycles of the treatment were 3. The total response rate was 8.69%. The stable disease rate was 47.82%. The median time to diease progression was 2.7 months and the median survival time was 8.0 months. The 1-year survival rate was 26.08%. The main toxicity was hematological toxicity. GradeⅠ-Ⅱ leukopenia was seen in 18 patients (78.26%). GradeⅠthrombocytopenia was seen in 2 patient (8.69%). Conclusion Alimta is an effective therapy for the patients with advanced NSCLC. The efficacy improved and the toxicities can be tolerated.