Lung cancer has the highest mortality among all cancers around the world. In this case, the patient has a large non‑small‑cell lung carcinoma of left lower lung. He also suffered from three‑vessel coronary artery lesions, two of which were severe coronary artery stenosis, with proximal stenosis in about 90% of the circumflex coronary and about 80% of the right coronary artery. He also manifested moderate pulmonary ventilation dysfunction and mental symptoms before surgery. The patient's condition was complicated, and the perioperative management was difficult. After detailed preoperative evaluation, measures such as prevention of myocardial ischemia, lung protective ventilation strategy and goal‑directed fluid therapy were adopted during the operation, and the operation was successfully completed, patient was discharged peacefully. The experience of this case was summarized, so as to provide reference for perioperative management of lung cancer.