The research on targeted drugs for primary lung cancer has developed rapidly in recent years. Among them, Epidermal Growth Factor Receptor-tyrosine kinase inhibitors (EGFR-TKIs), which aim on the EGFR gene target, can affect the vast majority of EGFR mutations. Type patients have good effect. However, EGFR-TKIs have little effect on wild-type patients or patients with drug-resistant mutations. Therefore, EGFR mutation status must be detected before targeted therapy. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) can predict EGFR mutation status in patients who are not eligible for invasive genetic testing. This article reviews the research progress of 18F-FDG PET/CT imaging in the prediction of EGFR gene mutation status in lung adenocarcinoma.