The application scope of immunotherapy has gradually expanded from advanced non-small cell lung cancer to the perioperative stage, with three core clinical application forms progressively established: neoadjuvant therapy, adjuvant therapy, and comprehensive management combining neoadjuvant and adjuvant approaches. Recent clinical studies have demonstrated that all three treatment modalities can achieve improvements in pathological response and event-free survival. However, consensus remains elusive regarding the characteristics of beneficiary populations, efficacy differences among various treatment strategies, and perioperative-specific safety risks. By integrating recent clinical research findings and systematically reviewing evidence-based data for each therapeutic approach, this review aims to provide evidence-based support for rational clinical treatment selection.