Objective The objective of this study is to find individualized, evidence-based treatment for a patientwith extensive small cell lung cancer, malignant pleural effusion, and liver metastasis.Methods According to the PICO (patient intervention comparison outcome) principle, evidence was collected and critically assessed. The patient’s preference was also taken into consideration in the decision making process. Results We included 10 randomized controlled trials, 13 systematic reviews and meta-analyses, and three clinical guidelines. The evidence indicated that chemotherapeutic treatment prolongs survival in patients with extensive small cell lung cancer and AiDi injections could relieve adverse effects caused by chemotherapy or radiotherapy. Cisplatin and etoposide are considered major standard cytotoxic drugs for small cell lung cancer. We drained the pleural cavity and infused Bleomycin into the pleural cavity. We also used an EP regimen of chemotherapy after the patient’s condition had improved. This patient survived longer than the average survival time for small cell lung cancer patients and has enjoyed a higher quality of life. Conclusion Chemotherapy is the main medical treatment for patients with extensive small cell lung cancer, backed up by symptomatic treatment and supportive care. Prophylactic cranial irradiation decreases brain metastases incidence and improves survival in complete response small cell lung cancer patients.