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Background: Early diagnosis is one of the most critical factors influencing the prognosis of lung cancer. This study aims to investigate radiological diagnostic delays and their underlying causes in lung cancer. Methods: The previous radiological images of newly diagnosed lung cancer patients were retrospectively reviewed by a multidisciplinary team consisting of 2 chest physicians and 1 radiologist. Radiological abnormalities were identified, and potential factors contributing to delayed diagnosis were analyzed. Results: Among 100 patients, 76 had prior thoracic imaging. In 22 of these, lesions had been previously identified and patients informed about the potential risk of malignancy, but further evaluation was declined. Retrospective review revealed unrecognized radiological abnormalities in 30 patients—12 on chest X-rays and 18 on computed tomography (CT) scans. In 7 cases, the lesions had been documented in the CT reports. Lesions located in peri-hilar, tracheobronchial, and paravertebral regions, as well as those originating from areas of lung sequelae, were among the most common factors associated with later diagnosis. Diagnostic delays were more common in cases of adenocarcinoma. Conclusion: A considerable proportion of lung cancer cases might have been detected earlier. Increased awareness of specific radiological features and careful co-evaluation of both imaging reports and the images themselves may enhance earlier detection in lung cancer. Cite this article as: Tokgöz Akyıl F, Abalı H, S.kücü SN, et al. Could it be diagnosed earlier? A retrospective analysis of lung cancer. Eurasian J Med. 2025, 57(2), 0893, doi:10.5152/ eurasianjmed.2025.25893.