Objective    To investigate the clinical effect of thoracoscopic lobectomy versus segmentectomy in the treatment of T1bN0M0 non-small cell lung cancer (NSCLC). Methods    Clinical data of 181 patients with T1bN0M0 NSCLC admitted to our hospital from 2012 to 2015 were retrospectively analyzed. They were divided into a lobectomy group and a segmentectomy group according to surgical methods. There were 117 patients in the lobectomy group (46 males and 71 females aged 61.32±8.94 years) and 64 patients in the segmentectomy group (20 males and 44 females aged 58.55±12.57 years). Perioperative indicators and prognosis were compared between the two groups. Results    The segmentectomy group had longer operation time, less intraoperative blood loss, shorter postoperative hospital stay and more preservation of lung function compared with the lobectomy group (P<0.05). The lobectomy group had higher consolidation tumor ratio, bigger tumor diameter, and more lymph node sampling compared with the segmentectomy group (P<0.05). There was no statistical difference in 5-year overall survival or recurrence-free survival between the two groups (P<0.05). Conclusion    For patients with T1bN0M0 NSCLC, thoracoscopic segmentectomy and lobectomy have similar prognosis, but segmentectomy has advantages with less injury and faster recovery over lobectomy.