Small cell lung cancer (SCLC) belongs to neuroendocrine malignancy and indicates an extremely poor prognosis. Concurrent chemoradiotherapy and first-line chemotherapy of SCLC rely on traditional medication such as etoposide and platinum, and the options after first-line treatment resistance are limited. In recent years, immunotherapy has emerged in the field of SCLC. Immunotherapy combined with chemotherapy has become the first-line standard of care for extensive-stage SCLC. ASTRUM-005 and CAPSTONE-1 studies confirmed that serplulimab and adebrelimab further prolonged the survival time of extensive-stage SCLC patients. Antivascular therapy has offered a new option for third-line or subsequent treatment of SCLC. Immunotherapy combined with antivascular therapy is advancing to the first-line treatment of extensive-stage SCLC, and is being explored in limited-stage SCLC. The development of limited-stage SCLC treatment has been slow. Some clinical researches on optimal timing, radiation dose and fractionation pattern of thoracic radiotherapy have made some progress. But the role of prophylactic cranial irradiation in limited-stage SCLC has been questioned by some clinical evidences. New medicine such as delta-like ligand 3 (DLL3) inhibitors and poly-ADP ribose polymerase (PARP) inhibitors gradually emerged, hoping to bring new breakthroughs in the treatment of SCLC. Meanwhile, the preliminary determination of molecular subtypes of SCLC is essential for precision therapy. Exploration of immunotherapy pattern in limited-stage SCLC, new immune checkpoint inhibitor medicine and different combination therapy strategies are designed in clinical trials for SCLC population. This review aims to summary the new advances in the treatment of SCLC.