A systematic review and meta-analysis of 21 studies with 41,780 patients identified risk factors for postoperative venous thromboembolism (VTE) in patients with lung cancer. Significant risk factors include age ≥ 65 years, hyperlipidemia, tumor stage III–IV, thoracotomy, operative time ≥ 2 hours, intraoperative blood loss ≥ 200 mL, abnormal D-dimer levels, and preoperative chemotherapy. No statistically significant associations were found with sex, age ≥ 60 years, smoking, alcohol consumption, body mass index ≥ 25 kg/m², hypertension, heart disease, diabetes, pathologic tumor type, operative time ≥ 3 hours, tumor location, or lung resection type. Studies were searched in PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, CBM, and VIP databases until February 2025. Meta-analysis was performed with RevMan 5.4 software, and data were assessed by two independent reviewers. Targeted preventive measures based on these factors can improve clinical patient outcomes.