Because of the rapid response to crizotinib, patients with ALK-positive locally advanced disease may become resectable with the use of neoadjuvant crizotinib. A 41-year-old never-smoking man who presented with asthma attack was found to have a suspicious lesion on chest X-ray after. Pathological examination was consistent with ALK(+), the signet-ring cell adenocarcinoma. Surgery was not performed because of mediastinal invasion of the mass. After 4 weeks of crizotinib treatment, a major response was achieved and the tumor became completely cavitary. Short-term neoadjuvant therapy with crizotinib for 4 weeks might be a promising therapy in locally advanced ALK-positive NSCLC and might provide a chance for resectability.