To test the possible association between reversion-inducing cysteine-rich protein with Kazal motifs (RECK) genetic variants and susceptibility as well as the chemotherapy response status to in patients with advanced non-small cell lung cancer (NSCLC). We recruited 304 patients who were histologically diagnosed as advanced NSCLC (IIIa, IIIb, and IV stage) in our hospital from September 2003 to January 2008. We also enrolled 409 sex- and age-matched healthy volunteers as controls. RECK Gene Polymorphisms were determined. Only the genotype distributions and allele frequencies of rs10814325 T>C were significantly different between NSCLC and controls (both P < 0.001). By multivariate analyses, markedly higher risk for NSCLC was observed in rs10814325 CC genotype (adjusted OR = 2.302, P = 0.012, with TT as reference) after adjustment with age, sex, smoking status, histology, differentiation, and stage. Haplotypes analyses showed that the A(rs11788747)-G(rs16932912)-C(rs10814325) and A(rs11788747)-A(rs16932912A)-C(rs10814325) were associated with higher risk for NSCLC; however, G(rs11788747)-G(rs16932912)-T(rs10814325) and G(rs11788747)-A(rs16932912)-T(rs10814325) haplotypes showed significantly protective roles in the NSCLC risk. The genotype and the allele frequencies of RECK gene were not significantly different between chemotherapy responder and non-responders. Multivariate logistic regression analysis showed no association between the RECK polymorphism and chemotherapy response status in this study. To the best of our knowledge, this is the first study documenting the etiological role of RECK genetic polymorphisms in NSCLC.