Perioperative stroke is a severe complication with poor prognosis in patients undergoing surgical treatment for lung cancer. It not only significantly increases postoperative mortality risk but also frequently leads to permanent neurological deficits, severely impairing patients' quality of life and adversely affecting long-term outcomes. With the continuous increase in the volume of lung cancer surgeries and the aggravation of population aging, the prevention and management of perioperative stroke have become an urgent clinical challenge in the field of thoracic surgery. However, there is currently a lack of systematic and standardized guidance documents specifically addressing the prevention and management of perioperative stroke in lung cancer surgery in China. To address this gap, experts in relevant fields in China developed this consensus based on the latest evidence-based medical evidence, systematically searching authoritative domestic and international databases, including high-quality clinical studies, guidelines, and systematic review published in the past decade, and incorporating the clinical characteristics of Chinese patients undergoing lung cancer surgery. The Delphi method was adopted to finalize the recommendations. This consensus has formulated 18 recommendations based on research related to perioperative stroke in lung cancer surgery, aiming to provide clinicians with standardized prevention and management strategies, thereby reducing the incidence of perioperative stroke and improving the prognosis and quality of life of affected patients.