Acrometastasis is a rare manifestation of metastatic disease that affects the distal extremities and can occur as a complication of non-small-cell lung cancer. It is often associated with advanced disease and may coincide with other skeletal or systemic metastases. Management options typically include a combination of surgical intervention, radiation therapy, and systemic treatment. This report presents a case of an isolated acrometastatic lesion in the fifth digit of a patient with stage IV squamous cell carcinoma, without evidence of additional metastatic bone involvement. We explore diagnostic and therapeutic strategies for such presentations and emphasize the importance of a multidisciplinary approach in optimizing patient care. We also address the underlying pathophysiology and potential mechanisms contributing to acrometastatic spread.