Abstract: Objective To explore the clinical effectiveness of three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with three-dimensional video-assisted thoracic surgery (3D-VATS) in precise pulmonary segmentectomy for the treatment of patients with early non-small cell lung cancer (NSCLC). Methods A total of 46 early NSCLC patients who underwent precise pulmonary segmentectomy under the guidance of 3D-CTBA combined with 3D-VATS from January 2017 to May 2019 were enrolled and their clinical data were retrospectively analyzed. Results All the patients successfully performed surgery without conversion to thoracotomy. The operation time was (200.1±74.2) min, and the perioperative blood loss was (60.7±38.7) ml. The number of lymph node dissection was (9.7±3.1) and the postoperative thoracic drainage was (190.5±70.8) ml. The retention time of chest tube was (5.2±1.7) days, and the average hospitalization time was (13.7±3.5) day. According to postoperative pathological results, there were 38 cases with minimally invasive adenocarcinoma and 8 cases with adenocarcinoma in-situ. The patients were followed-up for 8 months and no metastasis or relapse was reported. Conclusions The combined use of 3D-CTBA and 3D-VATS in precise pulmonary segmentectomy is safe and effective for the treatment of patients with early NSCLC.