Background: Significant racial and ethnic disparities exist in lung cancer care. Thus, minorities are diagnosed with late stage cancer and have inferior outcomes likely leading to increased suffering. Little is known, however, about disparities in supportive care needs among patients with advanced lung cancer. Methods: We performed a prospective cohort study of patients newly diagnosed with advanced lung cancer (stage III and IV). At baseline (within 3 months of diagnosis), patients completed a validated survey assessing needs among seven domains: medical communication and information, psychological and emotional support, daily living, financial concerns, physical symptoms, spiritual needs, and social needs. Univariate and multivariate regression analyses compared differences in supportive care needs among minority (Black and Hispanic) and non-minority patients with advanced lung cancer. Results: We have enrolled 95/160 patients (60%). To date, baseline surveys have been completed on 55 patients. Of those, 37 (67%) are minorities and 18 (33%) non-minorities. Minorities were less likely to be married (p = 0.01), had a lower annual income (p < 0.001), lower education attainment (p = .02) and more likely to have Medicaid (p < 0.001). There were no differences in gender (p = 0.35) or performance status (p = 0.13). Overall, 39% of minorities report having higher supportive care needs across all domains compared with 25% of non-minorities (p < 0.001). Similarly, minorities reported having significantly higher needs among each domain except medical communication and information (p = 0.06). Multivariate analysis, controlling for patient characteristics, found minorities had increased odds of overall supportive care needs (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.03-1.16). Conclusions: Minority patients with advanced lung cancer are more likely to have increased supportive care needs than non-minority patients. Ensuring minority patients have adequate supportive care evaluation and treatment is necessary to mitigating health disparities among patients with lung cancer. Future studies will be performed to evaluate how these needs change throughout the trajectory of lung cancer.