Lung cancer is one of the leading causes of cancer-related death worldwide. Lung cancer commonly metastasizes to the liver, bone, and brain, but metastasis to skeletal muscles is rare. The development of metastasis in skeletal muscles indicates stage IV disease with a poor prognosis. The most effective treatment strategy is unclear. Palliative radiotherapy is often used to treat skeletal muscle metastases, and patient survival is poor, with an average survival of one year. Here we discuss the case of a 76-year-old female diagnosed with lung adenocarcinoma with metastasis to the trapezius muscle. Initially, she was treated with stereotactic body radiotherapy for stage T1 lung adenocarcinoma. Her follow-up surveillance positron emission tomography (PET) scan in 11 months showed an abnormal focal area of increased activity localizing to the long head of the right triceps muscle. The diagnosis was confirmed with an ultrasound-guided biopsy of the trapezius muscle. Following that, the patient underwent wedge resection of the right middle and upper lobe of the lung and partial right trapezius resection. Afterward, she was given radiation therapy at the tricep resection site. She remained disease-free for four years after excision and radiation therapy.