Malignant neoplasms are sometimes associated with a variety of paraneoplastic rheumatic syndromes. Hypertrophic osteoarthropathy is one of these syndromes and the vast majority of cases are associated with intra thoracic neoplasms mainly broncogenic cancer. Hypertrophic osteoarthropathy (HOA) is characterized by clubbed fingers and periosteal new bone formation. Etiologically, it can be divided into primary and secondary HOA. The major clinical manifestation was severe bilateral leg pain. The pathogenesis of the disease remains unclear. Bone scintigraphy is a sensitive method to detect HOA. In this case, a 49-year-old man who had hypertrophic pulmonary osteoarthropathy associated with advanced stage non-small cell lung carcinoma is presented and a review of the literature is performed.