Current domestic and international lung cancer screening guidelines recommend the use of low-dose spiral computed tomography(LDCT)for lung cancer screening,which has significantly improved the detection rate of early-stage lung adenocarcinoma.According to the Chinese Medical Association's Lung Cancer Clinical Diagnosis and Treatment Guidelines(2024 Edition),patients with stage IA(T1a/b/cN0)lung adenocarcinoma who undergo surgery with negative surgical margins(R0)can have regular follow-ups postoperatively without the need for adjuvant therapy(Class I recommendation, evidence-based).Recent clinical studies have revealed that the prognosis of patients with stage IA lung adenocarcinoma who only receive surgical treatment is influenced by various factors. To further improve patient outcomes, discussions on the need for postoperative adjuvant therapy continue to emerge. Although a unified treatment standard has not yet been formed, this topic remains of significant research value. This article reviews the impact of factors such as tumor size, solid component ratio, micropapillary and solid subtype proportions, lymphovascular invasion(LVI),and the presence of spread through air spaces(STAS)on the prognosis of stage IA lung adenocarcinoma, and discusses the latest postoperative adjuvant treatment plans and their outcomes, providing new insights into the postoperative treatment of stage IA lung adenocarcinoma.