Introduction: This study evaluates the role of pet-ct in surgical planning for non-small cell lung cancer in contemporary surgical practice, assessing its impact on clinical outcomes, procedural accuracy, and patient safety in a retrospective cohort analysis. Materials and Methods: A retrospective cohort study was conducted on 400 patients from January 2016 to June 2023 at a tertiary care center. Patients were divided into PET-CT staged (n=200) and Conventional CT staged (n=200) groups. Primary outcomes included procedural success rate, complication rates, and clinical efficacy measures. Results: The PET-CT staged group demonstrated significantly improved primary outcomes compared to Conventional CT staged (p<0.05). Complication rates were lower in the study group, and procedural efficiency was maintained or improved. Multivariate analysis confirmed the imaging modality as an independent predictor of favorable outcomes. Cionclusion: The findings support the integration of advanced imaging guidance in surgical practice, demonstrating measurable improvements in accuracy, safety, and clinical outcomes that justify the investment in imaging technology.