PURPOSE: The aim of our study was to evaluate the value of coronal reformatted images using multi-detector computed tomography (MDCT) imaging in non small cell lung cancer (NSCLC) for the determination of lymph node (LN) metastasis. MATERIALS AND METHODS: Chest CT scans using MDCT were performed in 43 patients with pathologically proven NSCLC. The images were reconstructed with a 3 mm thickness in the axial and coronal planes. The axial images were examined for LN metastasis with and without the coronal reformatted images by the consensus of two radiologists on two separate occasions. RESULTS: In total, 214 nodal groups were dissected, of which, 33 (15.4%) were pathologically proven as LN metastasis. The sensitivity of diagnosis was higher when assessing both the axial and coronal reformatted images compared to the axial images alone (51.5% vs. 33.3%), whereas the specificity and accuracy was lower when examining both the axial and coronal reformatted images (65.7% vs. 87.8% and 63.6% vs. 79.4%). Despite this, the additional coronal reformatted images provided additional anatomical information which was helpful in the assessment of accurate nodal stations and the decline of the pitfalls. CONCLUSION: The value of coronal reformatted images for the diagnosis of nodal metastasis in NSCLC may still be unclear; however, the coronal reformatted images may lend support to the axial images in being able to provide additional anatomical information.