Objectives : We aimed to assess the relationship between long-term exposure to air pollution and lung cancer in the Republic of Korea. Methods : Using the Annual Report of Ambient Air Quality in Korea, Annual Report of National Cancer Registration, and Annual Report on the Cause of Death Statistics, we calculated the standardized mortality ratio (SMR) and standardized incidence ratio (SIR) of lung cancer for both sexes in 74 areas from 7 Korean metropolitan cities. We performed random intercept, Poisson regression using empirical Bayes method. Results : Both SMRs and SIRs in the 7 metropolitan cities were higher in women than in men. Mean SIRs were 99.0 for males and 107.0 for females. The association between $PM_{10}$ and lung cancer risk differed according to gender. $PM_{10}$ was not associated with the risk of lung cancer in males, but both incidence and mortality of lung cancer were positively associated with $PM_{10}$ in females. The estimated percentage increases in the rate of female lung cancer mortality and incidence were 27% and 65% at the highest $PM_{10}$ category $({geq}70;{mu}g/m^3)$, compared to the referent category $({geq}50;{mu}g/m^3)$. Conclusions : Long-term exposure to $PM_{10}$ was significantly associated with female lung cancer incidence in 7 Korean metropolitan cities. Further study is undergoing to estimate the relative risk of $PM_{10}$ using multi-level analysis for controlling individual and regional confounders such as smoking and socioeconomic position.