Objective To investigate the effects of early pulmonary rehabilitation training on lung function recovery， complication rates， and quality of life in patients who undergo thoracoscopic surgery. Methods A randomized controlled trial was conducted involving 132 patients who underwent thoracoscopic surgery between June 2020 and June 2023. Participants were randomly allocated to either an early pulmonary rehabilitation program （n = 72） or a conventional rehabilitation program （n = 60）. The early intervention group commenced a staged rehabilitation protocol—including respiratory training and physical exercise—within 24 to 72 hours following surgery， whereas the conventional group received standard postoperative nursing care only. Outcomes measured included postoperative pulmonary function （FEV₁， FVC）， incidence of postoperative complications， length of hospital stay， and quality of life scores （maximum score： 40）. These outcomes were compared between the two groups. Results On postoperative days 3 and 7， the early group showed significantly higher FEV₁ values compared to the conventional group ［（1.6 ± 0.17） L vs. （1.3 ± 0.21） L； （1.9 ± 0.20） L vs. （1.6 ± 0.11） L， respectively］， as well as improved FVC measurements ［（2.5 ± 0.20） L vs. （2.1 ± 0.14） L； （2.9 ± 0.25） L vs. （2.3 ± 0.23） L （all P < 0.05）］. The early intervention group also demonstrated a significantly lower overall complication rate （14.3% vs. 33.3%， χ2 = 6.79， P = 0.009）， including reduced incidences of atelectasis （6.9% vs. 20.0%， P = 0.031） and pulmonary infection （4.2% vs. 13.3%， P=0.044）. Additionally， patients in the early group had a shorter average hospital stay ［（8.4 ± 1.2） days vs. （10.9 ± 2.3） days， P = 0.018］ and reported higher quality of life scores ［（35.6 ± 3.7） vs. （30.8 ± 4.5）， P = 0.032］. No significant difference was observed between the two groups in terms of the overall incidence of adverse events （23.6% vs. 31.7%， χ2 = 1.07， P = 0.301）. Conclusions Early pulmonary rehabilitation significantly facilitates the recovery of lung function， reduces the incidence of postoperative complications， enhances quality of life， and demonstrates a favorable safety profile among patients undergoing thoracoscopic surgery. Therefore， this intervention should be more broadly implemented in clinical practice to optimize postoperative recovery outcomes.