Abstract: Current guidelines recommend anatomic lobectomy combined with systematic lymph node dissection as the standard procedure for early-stage lung cancer. With increasing health awareness and the popularity of low-dose computed tomography (LDCT), more small peripheral nodules are being detected, many of which have a pathological histology of lung adenocarcinoma. In recent years, surgeons have increasingly adopted precise resection techniques that completely remove tumors while preserving lung tissue and function. This approach has made surgical treatment minimally invasive and precise and also improved patient prognosis. This article reviews the impact of preoperative radiographic findings, surgical approaches, lymph node dissection methods, intraoperative frozen sections, pathological subtypes, and new pathological grading systems on the diagnosis, treatment, and prognosis of stage ⅠA lung adenocarcinoma.