Objective To explore the factors influencing kinesiophobia in lung cancer patients following thoracoscopic surgery, and to provide a basis for the development of targeted interventions.Methods A convenience sampling method was employed to select 480 lung cancer patients who underwent thoracoscopic surgery from June to November 2024.Data were collected using a general information questionnaire, the Kinesiophobia Scale (TSK), the Visual Analog Scale (VAS), the Self-Efficacy Scale, the Simplified Coping Style Questionnaire, the Hospital Anxiety and Depression Scale, and the Social Support Rating Scale.LASSO regression was used to screen feature variables, followed by logistic regression analysis of the selected variables.Results The average TSK score among the 480 patients was (40.18±14.51) points, with a kinesiophobia incidence rate of 39.17%.Factors influencing kinesiophobia in postoperative patients included personal monthly income, education level, surgical history, pain intensity, self-efficacy, social support level, anxiety level, and positive coping styles (all P＜0.05).Conclusion The incidence of kinesiophobia in lung cancer patients after thoracoscopic surgery is relatively high.Clinical healthcare providers should pay particular attention to patients with lower income, lower education levels, a history of surgery, higher pain intensity, and elevated anxiety.Interventions should aim to enhance patients′ self-efficacy and social support levels, while encouraging the adoption of positive coping strategies to reduce the risk of kinesiophobia during rehabilitation training.