Objective To explore the correlation between taste change its nutritional status and cancer fatigue in lung cancer chemotherapy patients. Method Retrospective analysis of 137 patients with lung cancer chemotherapy collected in Suzhou Hospital of Traditional Chinese Medicine from February 2021 to February 2024 for chemotherapy-related taste change scale CiTAS nutritional risk screening NRS 2002 cancer fatigue CFS status assessment Pearson method and linear regression analysis of CiTAS score NRS 2002 score and CFS score. Result Basic taste change score 15. 52±2. 52 taste abnormalities and taste hallucinations 9. 12± 2. 63 eating distress 20. 15±2. 35 overall taste change 12. 35±2. 89 CiTAS score 57. 13±7. 78 NRS 2002 score 4. 89± 2. 22 physical fatigue 24. 86± 2. 84 emotional fatigue 12. 36± 2. 39 cognitive fatigue 11. 78± 2. 55 CFS score 49. 01± 6. 60 points. Analyzed by the Pearson method total score of CiTAS was positively correlated with NRS 2002 score physical fatigue emotional fatigue cognitive fatigue and CFS total score After a linear regression analysis NRS 2002 The score and the total CiTAS score will affect the total CFS score By the analysis of the mediation effect NRS 2002 Score β = 0. 469 P<0. 001 and total CiTAS score β = 1. 105 P<0. 001 can significantly and positively predict the total CFS score The CiTAS total score plays a partial mediating role in the influence of NRS 2002 score and CFS total score the mediation effect accounted for 21. 17% of the total effect proportion. Conclusion Lung cancer chemotherapy patients taste change symptoms moderate to severe level and will directly affect the nutrition and cancer fatigue taste change the more serious nutritional status cancer fatigue the more serious a positive correlation to actively develop nutrition support adjust food taste to meet the demand of patients to ensure enough nutrition intake improve physical and mental health.