Lung cancer is one of the most prevalent and lethal malignancies worldwide posing a significant threat to human health. In recent years exercise therapy has emerged as a promising non-pharmacological intervention for the prevention treatment and rehabilitation of lung cancer. Clinical studies demonstrate that exercise effectively improves cardiopulmonary function in lung cancer patients enhancing peak oxygen uptake and 6-minute walk test performance thereby alleviating postoperative dyspnea and increasing physical endurance. Additionally exercise enhances muscle mass and exercise capacity reduces the risk of sarcopenia and lowers postoperative complications e. g. pneumonia atelectasis ultimately shortening hospital stays and improving quality of life. At the mechanistic level exercise influences lung cancer progression through multiple pathways. First it modulates the tumor microenvironment TME by promoting immune cell infiltration e. g. CD8 + T cells and potentially converting "immune-desert" or " immune-excluded" TME into an " immune-inflamed" phenotype thereby enhancing anti-tumor immunity. Second exercise affects tumor angiogenesis ameliorates hypoxia and regulates key factors such as vascular endothelial growth factor . Furthermore exercise promotes cancer cell apoptosis by upregulating tumor suppressor p53 and activating the BAX/ BAK-Caspase - 3 apoptotic pathway thereby inhibiting tumor growth. However different exercise modalities e. g. endurance training vs. high-intensity interval training HIIT exhibit varying effects on the immune microenvironment and the underlying mechanisms require further investigation. Exercise therapy has important clinical application value in the management of lung cancer which can not only improve the physiological function and quality of life of patients but also synergistically enhance the anti - tumor effect through immune regulation and pro apoptotic effect. This article aims to summarize the clinical effect and mechanism of action of exercise therapy.