Background: Well-differentiated neuroendocrine tumors (NET) of the lung account for 2% of all primary lung neoplasms. Less than 2% of the lung NET present with the carcinoid syndrome manifested as facial flushing, diarrhea, palpitation, and bronchospasm, as a result of a hypersecretion of hormones and peptides from the tumor. Carcinoid crisis is a life-threatening complication of the carcinoid syndrome and its manifestation as coronary vasospasm is rare. Octreotide is a gold-standard treatment to control the symptoms; however, octreotide as a triggering factor for coronary vasospasm has never been reported. Case description: A 62-year-old man presented with multiple episodes of carcinoid symptoms is referred to our hospital. A series of investigations were carried out and he was diagnosed with the lung NET with a liver and bone metastasis. He developed coronary vasospasm, which could be due to the carcinoid crisis itself or the treating agent octreotide, after initiation of octreotide for carcinoid syndromes. After intense perioperative management by multidisciplinary teams, he underwent successful symptom control by perioperative octreotide and surgery. Conclusion: Surgery is the mainstay treatment to control carcinoid syndromes or crisis. Multidisciplinary therapy in perioperative care is paramount to ensure an optimal surgical outcome.