A review of available data of a total of 149 male, heavy-smoking patients who underwent lung resection and lymph node dissection for roentgenographically occult lung cancer revealed 37 cases of exophytic squamous cell carcinoma that macroscopically protruded into the bronchial lumen. The 37 tumors were studied by both gross examination and inspection of serial blocks sectioned perpendicularly to the axis of bronchi. The macroscopic features of the exophytic tumors were classified into four types: annular constrictive (AC) in 4, polyp with superficial extension (PSE) in 14, pedunculate localized polyp (PLP) in 7, and nonpedunculate localized polyp (NLP) type in 12 cases. An AC lesion showed the annular growth narrowing the bronchus. A PSE was a lesion in which tumor protruded in the center and spread superficially in proximal and distal directions from the margin of protrusion. A PLP was a polypoid tumor that was localized in a small area with a stalk. A NLP was a polypoid tumor with a broad base that was localized in a small area without superficial invasion. Cases of each of the four types were investigated histologically and lung-saving procedures for this group of tumors were retrospectively discussed. The numbers in this series are small; however, the following hypotheses were inferred. Bronchoscopy might make it possible to differentiate these four types prior to operation. The PLP type is most suitable to lung-saving procedures, whereas lymph node dissection should be carried out for the AC type. At least 50% of patients with the AC type had extrabronchial invasion and 25% had N2 nodes. Lymph node dissection should also be carried out in patients with the NLP type, especially those with a transverse diameter ≥6 mm. For the PSE type, frozen section should be checked at the time of surgery to ensure complete resection of the tumor.