Objective To explore the influencing factors of prolonged preoperative hospitalization in elderly patients with lung cancer undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on 1 848 lung cancer patients aged over 65 years who had undergone thoracoscopic lobectomy in Chinese PLA General Hospital from January 2013 to December 2019. Their preoperative data were collected from the hospital information system (HIS), including general information, medical history, results of laboratory tests, consultation and other preoperative diagnosis and treatment data. According to their preoperative hospital stay, they were divided into normal group (≤6 d, n=755) and prolonged group (>6 d, n=1 093). SPSS statistics 24.0 was used to analyze the data. Based on different data type, student′s t test, Mann Whitney U test or Chi-square test was employed for intergroup comparison. Multivariate logistic regression analysis was applied to determine the influencing factors of prolonged preoperative hospital stay. Results Among these 1 848 elderly patients, 59.1% (1 093/1 848) of them had prolonged preoperative hospitalization. There were significant differences in age, diastolic blood pressure, neutrophils count, plasma activated partial thromboplastin time, plasma thrombin time, preoperative consultation, and proportions of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD) between the normal group and the prolonged group (P<0.05). Multivariate logistic regression analysis showed that age >70 years (OR=1.275,95%CI 1.024-1.587), CHD (OR=1.523,95%CI 1.021-2.274), COPD (OR=1.360,95%CI 1.042-1.775) and preoperative consultation (OR=1.310,95%CI 1.046-1.641) were independent influencing factors for the prolongation of preoperative hospitalization time in elderly lung cancer patients. Conclusion Among the elderly lung cancer patients who planned to undergo thoracoscopic lobectomy, age>70 years, CHD, COPD and preoperative consultation are the influencing factors for the prolongation of preoperative hospitalization.