Non-small cell lung cancer remains the leading cause of cancer-related mortality worldwide, with a substantial proportion of patients presenting with stage IV disease and a poor 5-year survival rate not exceeding 12%. Oligometastatic disease (OMD) represents an intermediate state between localised and widely disseminated disease, characterised by a limited number of metastases (maximum five in not more than three organs, according to the most commonly used definition) and potentially more favourable tumour biology. The therapeutic landscape has evolved significantly with the introduction of immune checkpoint inhibitors and chemo- immunotherapy, which have improved systemic disease control. In parallel, advances in local ablative therapies (LAT), including stereotactic body radio- therapy and surgery, have allowed for high local control rates with acceptable toxicity. Increasing evidence suggests a synergistic interaction between radiotherapy and immunotherapy, supporting the use of combined treatment strategies. This narrative review aims to address key clinical dilemmas in the management of OMD, including whether all metastatic sites or only selected or progressing lesions should be treated, the optimal timing of radiotherapy in relation to immunotherapy, and the appropriate duration of immunotherapy. By commenting on the current evidence with real-world clinical scenarios, we aim to provide a practical framework for individualised multimodal treatment strategies.