Abstract: Small cell lung cancer (SCLC) is a highly malignant neuroendocrine tumor, which is prone to metastasis and is associated with a very poor prognosis. SCLC was previously regarded as a homogeneous disease that lacked individualized treatment strategies. In recent years, molecular typing studies have revealed the high heterogeneity of SCLC. However, issues such as inconsistent typing standards, the dynamic transformation of subtypes, and complex drug resistance mechanisms restrict the clinical translation of the results. This article systematically expounds the research progress of SCLC molecular typing, summarizes its potential and challenges in driving precision treatment, and aims to provide ideas for the development of precise medical treatment plans and promote the clinical translation of the "typing-guided treatment" model for SCLC.