Abstract: In recent years, significant progress has been made in perioperative immunotherapy for non-small cell lung cancer (NSCLC). Several international phase Ⅲ clinical trials (such as CheckMate-816, IMpower010, and KEYNOTE-091) have demonstrated that neoadjuvant and adjuvant immunotherapy can significantly improve pathological response rates, event-free survival (EFS), and disease-free survival (DFS) in patients with stage Ⅱ-Ⅲ NSCLC, leading to regulatory approvals worldwide. Moreover, further studies, including KEYNOTE-671, AEGEAN, and CheckMate-77T, have validated the potential advantages of the "neoadjuvant+adjuvant" immunotherapy approach. This approach has been proven to significantly reduce the risk of postoperative recurrence in certain populations. Additionally, biomarkers such as PD-L1 expression, minimal residual disease status, and ctDNA monitoring are being investigated as predictive indicators for optimizing individualized treatment strategies. However, there remains controversy regarding the choice of perioperative immunotherapy mode, optimal treatment cycle, and application of this treatment approach in patients with driver gene mutations. Future research will continue to explore the efficacy of immunotherapy in different patient subgroups to maximize the clinical benefits while minimizing the toxicity risks associated with this treatment approach.