Context: MGMT, is a DNA repair protein involved in removing the mutagenic and cytotoxic adducts from O6-guanine in DNA, which otherwise can lead to the mutation, primarily due to the tendency of O6-methylguanine to pair with thymine during replication, resulting in the conversion of GC to AT pairs, if left unrepaired due to epigenetic silencing of its promoter. Aims: To study the status of MGMT in Kashmiri lung cancer patients Materials and Methods: In this study we analyzed the promoter status of this gene in 50 lung cancer patients using methylation specifi c-PCR and confi rmed by restriction digestion. Results: The promoter was found to be methylated in 52% of the cases, more in male patients (54.2%) than in female patients (46.6%). When stratifi ed according to smoking status, current smokers showed a strong association with methylation (OR = 6.0, P = 0.005) than former and never smokers. We also compared the promoter methylation of the MGMT gene with pesticide exposure, and found that patients with pesticide exposure had statistically signifi cant (OR = 7.7 and P = 0.003) association with promoter methylation. Conclusions: Our results indicate that MGMT promoter methylation is associated with smoking exposure and there appears to be an association of MGMT promoter methylation with pesticide exposure in Kashmiri lung cancer patients.