A lung nodule (white spot < 3 cm in diameter) can either be first detected on a chest radiograph or a Computed Tomography (CT) scan. When detected on the radiograph, the next step is almost always a CT scan. When first detected on a CT scan, the next step is the comparison with any imaging studies available from the past. If no past imaging is available for comparison, then the next step is a biopsy, which is also the gold standard for diagnosis. Although observation with interval imaging has been advocated, this approach is only safe when the likelihood of the nodule being benign is very high. Otherwise, a biopsy should be undertaken to exclude or confirm cancer in the early stage as it carries implications for survival. It should be kept in mind that missing lung cancer when it is just a nodule is a bigger error than missing a lung cancer when someone presents with a mass on the imaging studies. This is because the former error can render a curable patient incurable whereas the latter may not cause any reversible harm. CT scan does not carry a significant risk of harm from radiation as the prevalent notion in the society. Modality for biopsy largely depends on the location of the nodule and its accessibility via various modalities. The peripheral nodules are easier to access by transthoracic needle aspiration whereas the central nodules are easier to access via bronchoscopy or endobronchial guided transbronchial needle aspiration (EBUS-TBNA). Occasionally, video assisted surgical biopsy may be needed and should be offered promptly when indicated. Reliance on Chest radiograph alone and lung cancer probability calculators should be minimised.