The existing guidelines do not recommend postoperative adjuvant therapy for patients with stage ⅠA lung adenocarcinoma. However, patients with stage ⅠA lung adenocarcinoma containing clinical high-risk factors have a higher risk of recurrence and metastasis, and surgery alone may not be sufficient to ensure long-term efficacy. How and when to carry out postoperative adjuvant therapy to improve the survival of stage ⅠA patients with high risk of recurrence become a problem that needs to be solved in the future. This article will discuss the research progress of the prognosis and postoperative adjuvant therapy of stage ⅠA lung adenocarcinoma patients with high-risk factors (T stage, consolidation tumor ratio, high-grade pathological subtypes and percentage, spread through air space, lympho-vascular invasion, etc.).