Abstract: Objective To explore the application of comprehensive geriatric assessment (CGA) in elderly patients with non-small cell lung cancer (NSCLC), identify aging-related risk factors influencing the prognosis of these NSCLC patients and evaluate the impact of CGA-based individualized postoperative management on patient recovery. Methods A combined retrospective and prospective research method was adopted. The retrospective study included 300 elderly patients treated in Jiangyin People's Hospital, and the patients were divided into a lung cancer group (n=150) and a control group (n=150). The independent risk factors associated with NSCLC were identified by univariate and multivariate analyses. The prospective study included 80 elderly NSCLC patients and these patients were randomly divided into a study group and a control group (n=40). The study group received CGA-based individualized postoperative management, while the control group underwent standard postoperative management. Follow-ups were conducted to evaluate postoperative recovery, including quality of life, functional status, and incidence of complications. Results Smoking history, alcohol consumption, frailty, malnutrition, anxiety, and depression were identified as independent risk factors for NSCLC in elderly patients, whereas high-density lipoprotein showed protective effect. CGA-based individualized management significantly improved postoperative recovery in elderly NSCLC patients, including enhanced quality of life, reduced complication rates, and shortened the length of hospitalization stays (P<0.05). Conclusions CGA is crucial in managing elderly NSCLC patients which can identify a broader range of aging-related risk factors and optimize individualized treatment. Its widespread application in clinical practice is recommended to improve patient prognosis.