Objective To explore the application of enhanced recovery after surgery (ERAS) combined with the active health concept in the nursing care of lung cancer patients, and its impact on patients’ compliance with rehabilitation exercises, hospitalization satisfaction, incidence of postoperative complications, and length of hospital stay. Methods A prospective study design was adopted. Lung cancer patients admitted to the Department of Thoracic Surgery, West China Tianfu Hospital of Sichuan University between April and July 2025 were enrolled. Using a non-concurrent control method in a quasi-experimental study, the patients were divided into two groups. The control group received routine ERAS nursing, while the intervention group received additional active health interventions on top of ERAS. These interventions included patient participation in personalized plan formulation, patient empowerment (self-evaluation and independent recording of exercise status), daily one-on-one bedside guidance with positive psychological encouragement from nurses, and optimized perioperative education protocols. Four indicators were compared between the two groups: daily exercise frequency from admission to one month after discharge, hospitalization satisfaction, incidence of postoperative complications, and length of hospital stay. Results The intervention group demonstrated significantly better outcomes than the control group in terms of average daily in-hospital exercise frequency (2.2±0.5 vs. 1.6±0.7; t=5.797, P<0.001), planned average daily out-of-hospital exercise frequency on the day of discharge (3.2±0.9 vs. 1.9±0.8; t=9.038, P<0.001), actual average daily out-of-hospital exercise frequency (3.6±1.5 vs. 2.4±1.4; t=4.932, P<0.001), and satisfaction score on the day of discharge (97.9±4.4 vs. 95.8±5.5; t=2.378, P=0.019). No statistically significant difference was observed between the two groups regarding the incidence of postoperative complications or length of hospital stay (P>0.05). Conclusions The nursing model combining ERAS with the active health concept can effectively increase the frequency of rehabilitation exercises and improve hospitalization satisfaction among lung cancer patients. This combined model is superior to ERAS nursing alone and is worthy of clinical promotion and application.