Abstract: The present work aims to investigate the characteristics of papillary adenocarcinoma of the lung (PAL) and to analyze the prognostic factors associated with this disease. Methods: Clinical data of 142 PAL patients who were admitted to the Tianjin Medical University Cancer Institute and Hospital during the period from September 1970 to November 2008 were retrospectively reviewed. Age, sex, smoking history, family history of tumor, and TNM stages were analyzed. Survival rates were calculated using the Kaplan-Meier method and were compared using log-rank test. Univariate and multivariate factors for the survival rates were analyzed using the Cox proportional hazards regression model. Results: Clinical characteristics were similar in patients with PAL compared with those of other adenocarcinomas. The overall 1-, 3-, and 5-year survival rate was 60.0%, 34.5%, and 25%, respectively. Cox univariate analysis revealed that sex, smoking history, tumor size, lymph node metastasis, and TNM stages were prognostic factors associated with PAL. Cox multivariate analysis showed that smoking history, tumor size, and lymph node metastasis were independent prognostic factors. Conclusion: A successful diagnosis mainly depends on postoperative pathological analysis because clinical specificity is insufficient in diagnosing PAL. Smoking history, tumor size, and lymph node metastasis are the crucial prognostic factors associated with PAL.