Background: Remote digital symptom monitoring systems (rSMS) have been increasingly used in recent years to monitor symptoms, health-related quality of life, and other patient-reported outcomes in lung cancer. Previous studies have demonstrated variability in study design, types of rSMS, and outcomes used to assess benefits for patients and health care systems. However, there remains a lack of synthesized evidence pertaining to the similarities and differences among rSMS, including their theoretical underpinnings, key functional components, and reported benefits and limitations. Objective: This review aims to identify and synthesize existing research to map the current landscape of rSMS in lung cancer, including the theoretical foundations for its development and implementation, as well as its types, applications, and outcomes. Methods: This scoping review followed the Joanna Briggs Institute scoping review framework and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A comprehensive literature search was conducted from database inception to October 16, 2025, across 7 English-language databases and 3 Chinese-language databases (CNKI, WanFang, and SinoMed). Eligible studies were peer-reviewed original research articles examining rSMS among adults with lung cancer. Data were independently screened and extracted by 2 reviewers, with discrepancies resolved by a third reviewer. Quantitative data were extracted using a standardized form and synthesized descriptively. Content analysis was performed to analyze the qualitative data. Results: A total of 41 studies involving 11,765 patients and 85 health care providers were included. Twelve studies focused exclusively on advanced-stage lung cancer. Participants were generally middle-aged to older adults (mean ages 51‐74 y), with male participants typically comprising 30% to 50% across studies. Most studies were conducted in the United States (n=19). We identified 32 patient-reported outcome measures that were used either as core rSMS components or as study outcomes. Four common functional modules were observed across rSMS: data collection, data analysis, response systems, and patient education. Qualitative evidence was limited; the most frequently reported benefit was the promotion of patient-centered care. Health care providers raised concerns about uncertain effectiveness and increased workload. Conclusions: This scoping review highlights the promising role of rSMS in lung cancer care and provides a structured map of current evidence. It adds to prior literature in 3 ways. First, it summarizes how and how often theoretical frameworks are reported and applied in rSMS development and implementation. Second, it synthesizes and categorizes four common functional modules across systems. Third, it differentiates measures embedded as rSMS components from those used as evaluation outcomes. These contributions clarify current practices and methodological gaps and underscore the importance of theory-informed design, functional clarity, and stakeholder engagement in the development of patient-centered, clinically meaningful, and sustainable rSMS platforms. Trial Registration: OSF Registries 9637t; https://osf.io/9637t/overview
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