[Abstract] Objective: To compare the clinical results of lobectomy and segmentectomy in the treatment of invasive lung adenocarcinoma (LUAD) with a diameter ≤2cm, and to explore the risk factors affecting the prognosis of invasive LUAD patients undergoing surgery. Methods: The clinical data of invasive LUAD patients with diameter ≤2cm who received surgical treatment from January 2013 to December 2016 were retrospectively analyzed. The groups were divided into lobectomy and segmentectomy groups according to the surgical strategy. Overall survival and progression-free survival were compared by Kaplan-Meier method, and independent risk factors affecting prognosis of patients were analyzed by Cox regression. Results: The overall survival rates at 3 and 5 years were 99.3% and 96.2% for patients in the lobectomy group and 98.8% for patients in the segmentectomy group at both 3 and 5 years, respectively (P=0.159); the progression-free survival rates at 3 and 5 years were 92.9% and 89.0% for patients in the lobectomy group and 94.1% for patients in the segmentectomy group at both 3 and 5 years, respectively (P=0.071). Cox regression analysis suggested that age and whether the lymph nodes were positive were independent risk factors for overall postoperative survival and progression-free survival (P<0.05). Conclusion: Under strict control of surgical indications, segmentectomy for invasive lung adenocarcinoma with a diameter≤2cm has the same safety and prognosis as lobectomy.