Objective To explore the impact of symptom clusters on the level of fear of disease progression in postoperative lung cancer patients and provide references for strengthening symptom management to alleviate patients′ fear of disease progression. Methods A total of 228 primary lung cancer surgery patients were selected through convenient sampling. The general information questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF), and Chinese version of M.D. Anderson Symptom Inventory-Lung Cancer Module (MDASI-L) were used for the investigation. Results The total score of FoP-Q-SF was (29.75±9.10). The top three prevalent symptoms were fatigue (98.25%), pain (97.81%), and cough (95.61%). The severity of symptoms was highest for pain ［5.00 (3.00, 8.00)］, followed by fatigue ［5.00 (3.00,7.00)］, and restless sleep ［5.00(2.00,7.00)］. Exploratory factor analysis revealed three symptom clusters:disease behavior-psychoemotional symptom cluster, lung cancer-specific symptom cluster, and gastrointestinal-neurological symptom cluster. Spearman correlation analysis showed positive correlations between the total score and dimension scores of FoP-Q-SF and the three symptom clusters (rs=0.467-0.683, all P<0.05). Multiple linear regression analysis indicated that the disease behavior-psychoemotional symptom cluster and the lung cancer-specific symptom cluster were influencing factors for patients′ fear of disease progression (all P<0.05). Conclusion Postoperative lung cancer patients exhibit various symptom clusters, and the more severe the symptom clusters are, the higher the level of fear of disease progression. The result suggests that healthcare professionals should manage symptom clusters in postoperative lung cancer patients to alleviate their fear of disease progression, thereby improving their quality of life.