Objective: To explore the epidemiological, behavioral, and clinical determinants contributing to the increased incidence of lung cancer in Eastern Libya between 2017 and 2022. Methods: A retrospective, cross-sectional hospital-based study was conducted at Benghazi Medical Center. Out of 484 lung cancer cases diagnosed between 2017–2022, 348 were systematically sampled. Patient records were analyzed for demographic, clinical, and behavioral characteristics. Results: Of the 348 patients, 90% were male with a mean age of 62 years. Tobacco smoking was the most common risk factor (81%). Adenocarcinoma was the most frequent histological type. Most cases were diagnosed at Stage III/IV. In 2022, lung cancer was the leading cause of cancer-related death in the region (58 deaths). Hemoptysis and dyspnea were the most reported symptoms. Obese patients were typically non-smokers, while smokers were frequently underweight or normal BMI. Conclusion: Lung cancer in Eastern Libya is predominantly associated with tobacco use and late-stage presentation. Urgent public health interventions targeting smoking cessation and early detection are warranted................. Key words:........... Lung cancer, Tobacco smoking, Hemoptysis, Dyspnea