Objective：To investigate the safety and efficacy of immune checkpoint inhibitors（ICIs）received by real-world lung cancer patients. Methods：In this multi-center retrospective study，the clinical data of 1 022 lung cancer patients treated with ICIs from January 1，2018，to September 31，2022，in four hospitals were analyzed. Results：Among the included population，577 patients （56.5%）experienced varying degrees of immune-related adverse events（irAEs）. The most common systems affected were the endocrine system（41.4%），lungs（14.5%），and heart（13.5%）. Comparing the clinical characteristics between the two groups， significant differences were observed in Eastern Cooperative Oncology Group（ECOG）performance status，PD-L1 expression，lung cancer pathology type，history of epidermal growth factor receptor tyrosine kinase inhibitor therapy，tobacco and alcohol habits，and previous chronic diseases（all P < 0.05）. Patients who experience irAEs had a higher disease control rate（95.8% vs. 89.6%，P < 0.001） and longer median progression-free survival（11.1 months vs. 9.4 months，log-rank P < 0.001）compared to those who did not experience irAEs. Conclusion：In the real world，the incidence of irAEs in lung cancer patients treated with ICIs is relative high，with extensive involvement and many influencing factors，but most cases are mild. The incidence of irAEs may be associated with better disease control rates and progression-free survival.