Objective: To analyze the impact of fitness and athletic lifestyle on micrometastasis indicators and prognosis in patients with non-small cell lung cancer (NSCLC) undergoing pulmonary lobectomy and segmentectomy. Methods: This retrospective analysis included 40 NSCLC patients, all of whom were fitness enthusiasts or athletes, treated at our institution from January 2020 to December 2021. These patients were divided into two groups: a lobectomy group and a segmentectomy group, each comprising 20 patients. We compared treatment outcomes, clinical indicators (operative time, intra-operative blood loss, chest drainage, length of hospital stay), micrometastasis indicators (CK20mRNA, CK19mRNA, CEAmRNA, lunxmrna) in peripheral blood, lung function (forced vital capacity, forced expiratory volume in 1 second), postoperative complications, and quality of life (physical, psychological, social, environmental) for both groups before and 6 months’ post-therapy. Results: ① No significant difference in healing effect between the two groups (P>0.05). ② The segmentectomy group showed reduced chest drainage and hospitalization time compared to the lobectomy group (P<0.05), with no significant difference in surgery time and intra-operative blood loss (P>0.05). ③ No significant difference in pre-therapy micrometastasis indicators between the groups (P>0.05). Post-therapy, both groups showed similar levels of CEAmRNA (P>0.05). ④ Pre-therapy lung function was comparable between groups (P>0.05), but post-therapy, the segmentectomy group had better lung function (P<0.05). ⑤ No significant difference in postoperative complication rates (P>0.05). ⑥ The segmentectomy group exhibited superior quality of life post[1]therapy in all aspects. Conclusion: Both pulmonary lobectomy and segmentectomy are effective in treating NSCLC in fitness and athletic patients. Lobectomy showed better outcomes in altering tumor micrometastasis indicators post-surgery, while segmentectomy was more favorable for postoperative lung function, chest drainage, and hospital stay. The choice of procedure should be tailored to the patient's individual condition, considering their active lifestyle and physical demands.