Objectives The research aimed to determine the effects of different surgical procedures on postsurgical pain and early prognosis. We reviewed the perioperative data of patients who underwent single/two-port television-assisted thoracoscopic pulmonary nodule surgery in the day surgery ward of Nanjing Drum Tower Hospital. Methods The clinical and follow-up data of 693 patients undergoing thoracoscopic for pulmonary nodules in the day surgery ward under the centralized management model of our hospital were retrospectively analyzed during the period of January 2021 to December 2022. The patients were divided into a single-port and a two-port thoracoscopy group. The propensity-matching was used to balance the baseline data and analyze the differences in postoperative pain and prognosis of the patientsin the two groups. Results After propensity score matching， the single-port group had lower intraoperative fentanyl consumption ［0.5（0.35，0.50）mg vs. 0.5（0.40，0.50）mg， P = 0.034］， remifentanil consumption ［0.48（0.33，0.63）mg vs. 0.53（0.35，0.73）mg， P = 0.031］， intraoperative hemorrhage［20（10，50）mL vs. 50（20，50）mL， P = 0.001］， and Visual Analogue Scale on postoperative third day ［2（2，4）point vs. 3（2，4）point， P = 0.007］， which were statistically different. There were no statistically significant differences between the two groups in terms of postoperative rescue analgesia， chest drainage volume， length of hospitalization， pain on postoperative 1st， 5th， 9th， and 30th days， postoperative cough， pulmonary complications within 30 days after surgery， and unplanned hospital visits. Conclusion Compared with two-port thoracoscopy， single-port thoracoscopic day surgery for pulmonary nodules is a safe and feasible procedure that can significantly reduce the use of intraoperative opioid analgesics and the pain level of patients on postoperative 3rd day.