Background: Women with lung cancer are vulnerable to psychological distress and social isolation, which may be related to the smoking-related stigma of the disease. We developed a group-based psychosocial intervention seeking to address the specific needs of this understudied patient population. The goal of this pilot RCT was to examine the feasibility and acceptability of delivering group-based psychosocial care via videoconference (i.e., Zoom). Methods: Women with NSCLC within 3 months of diagnosis completed baseline measures of their computer literacy and were then randomized to a group-based psychosocial intervention receiving coping skill training or a group-based attention control (AC) arm receiving psychoeducation. Both arms involved five, 60 min. videoconference sessions (groups of 3-5 patients) that were led by a master-level counselor. Participants completed one Zoom “practice run” prior to starting the group sessions. After the last session, they rated the overall experience of the intervention delivery and the specific software. Results: Seventy patients (mean age = 66 yrs with 54% over age 65; 71% non-Hispanic White; 50% college educated; 75% advanced stage) consented (63% consent rate) and 65 were randomized (intervention: N = 33; AC: N = 32). At baseline, 47% indicated that they use a computer daily while 50% said they rarely or never use a computer. Attendance was high in both arms (means: intervention = 3.18; AC = 3.56 with 63% attended all sessions). Across arms, 89% preferred a group-delivery and 92% preferred online delivery. The majority used a smartphone or tablet to participate (72%). Regarding the Zoom software, 71% said it was easy to use, 65% of women would recommend it to others, and 41% felt comfortable with it after one use (but 26% said they felt never comfortable with it). Only 44% thought that the sessions via Zoom were the same as they would have been in-person. Conclusions: It seems to be feasible and acceptable to deliver group-based psychosocial interventions via videoconference in women with NSCLC undergoing treatment. Challenges regarding scheduling the group sessions and familiarizing infrequent computer users with the technology were encountered but were resolved over the course of the trial. Clinical trial information: NCT03731585.