Objective Exploring the efficacy evaluation of medical tissue glue combined with microwave ablation in the treatment of peripheral lung cancer. Method A prospective study design was adopted. A total of 105 patients with peripheral lung cancer who met the inclusion criteria and were admitted to Bayingolin Mongolian Autonomous Prefecture People 's Hospital from January 2021 to December 2023 were selected. They were divided into an observation group n = 53 and a control group n = 52 using a random number table method. The control group was treated with microwave ablation while the observation group was treated with microwave ablation combined with medical tissue glue. The clinical efficacy of the two groups was compared after 3 years of follow-up the survival rate and recurrence rate of the two groups were statistically analyzed the Cox proportional hazards regression model was used to analyze the prognostic factors and the quality of life and incidence of complications of the two groups were compared. Result After 1 month of treatment the complete ablation rate disease control rate DCR and objective response rate ORR in the observation group were significantly higher than those in the control group P <0. 05 . After 3 years of follow-up the overall survival OS and progression-free survival PFS in the observation group were higher than those in the control group while the local recurrence rate was lower than that in the control group P <0. 05 . Cox regression analysis showed that combined treatment and tumor diameter ≤3 cm were independent protective factors for OS. Stratified analysis showed that the combined therapy had a more significant therapeutic effect on patients with tumor diameter ≤3 cm P <0. 05 . After 3 months of treatment the quality of life score in the observation group was higher than that in the control group P <0. 05 . The total incidence of complications in the observation group was lower than that in the control group and no severe complications occurred. Conclusion The combination of medical tissue glue and microwave ablation in the interventional treatment of peripheral lung cancer has better efficacy than microwave ablation alone. It can reduce the recurrence rate of patients improve their 3-year survival rate.