[Introduction] This study aims to compare treatment outcomes between stereotactic body radiation therapy (SBRT) and surgery in early-stage non-small-cell lung cancer (NSCLC). [Methods] Eligible studies of SBRT and surgery were retrieved through extensive search of databases of Pubmed, Medline, Embase and Cochrane library from 2000 to 2011. Original English publications in stage I NSCLC with adequate sample sizes (30 minimum for SBRT, 100 minimum for surgery) were included. SBRT studies with BED <100 Gy, fraction dose <8 Gy, or using more than 8 fractions were excluded. Data is presented as mean (95％ confident interval).[Results] Forty-six SBRT studies (3 322 patients) and 34 surgery studies (12 367 patients) published in the same era were eligible. The median age and follow-up duration were 74 years and 27 months for SBRT patients, and 66 years and 42 months for surgery patients, respectively. The overall survival rates at 1-, 3- and 5-year with SBRT were 82.4% (79.8%~85.0%), 52.6% (48.4%~56.7%) and 37.3% (28.1%~46.4%), compared to 91.4% (88.8%~ 94.1%), 77.5% (72.9%~82.1%) and 67.5% (61.1%~74.0%) with full anatomical resection, and 90.2% (87.3%~93.2%), 71.8% (64.3%~79.3%) and 54.1% (42.2%~66.1%) with limited resection. The cause-specific survival at 3-year was 76.9% (71.6%~ 82.3%) vs. 79.6% (73.0%~86.2%) and 5-year 63.7% (53.6%~73.9%) vs. 67.1% (56.9%~77.4%), for SBRT and surgery. In SBRT group, overall survival was better with increasing operability of patients: with estimated operability of 50% for SBRT, the overall survival and disease free survival in SBRT group were not statistically different from that of surgery. [Conclusions] Collectively, SBRT offers inferior overall survival but similar cause-specific survival and local failure rates compared to that of surgery in patients with stage I NSCLC, but with more operable diseases enrolled into SBRT treatment, better outcome could be achieved and comparable to surgical approach. Randomized trial is needed to compare the efficacy of SBRT and surgery.