Abstract: Objective To analyze the clinical,genetic characteristics,and surgical outcomes of lung adenocarcinoma manifesting as ground-glass opacities (GGOs). Methods Patients with lung adenocarcinoma manifesting as GGOs who underwent surgery in our hospital from January 2014 to January 2019 were enrolled.Surgical outcomes,histopathology,genetic mutation status and survival data were collected. Results Among the 165 patients with GGOs,there were 65 males and 100 females.Twenty-nine (17.6%) patients had a history of smoking and they were all males.The average GGOs diameter was (13.63±7.16) mm.Among them,56 were with pure GGOs and 109 with mixed GGOs.VATS lobectomy was perfomed to 102 patients,segmentectomy to 18 patients,and wedge resection to 45 patients.The average station of lymph node dissection was (4.45±1.50),and the average number of lymph node resected was (11.32±7.97).Fifteen patients did not receive lymph node sampling.All patients were discharged from the hospital.Eight patients (4.8%) had postoperative complications and were cured after active treatment.Pathology results revealed that 7 (4.2%) cases had atypical adenoma-like hyperplasia (AAH),19 cases (11.5%) had adenocarcinoma in situ (AIS),32 cases (19.4%)had minimally invasive adenocarcinoma (MIA),and 107 cases (64.8%) had invasive adenocarcinoma (IPA).There were 31 cases with visceral pleura invasion and no lymph node metastasis was found.Of the 70 patients received genetic test,43 (61.4%) had EGFR mutations and 4 (5.7%) had KRAS mutations.The average follow-up time was (20.96±17.41) months.There was no follow-up data for 107 patients with IPA.No local recurrence and distant metastasis was observed in patients with MIA,AIS and AAH. Conclusion Greatsurgical outcomes and satisfied survival can be obtained through lobectomy or sublobectomy with or without lymph node resection for lung adenocarcinoma patients manifested as GGOs.Some patients have EGFR and other gene mutations,which may provide evidence for further targeted therapy.