Abstract: Postoperative recurrence and metastasis represent critical causes of treatment failure in early-stage non-small cell lung cancer (NSCLC), with the identification of high-risk factors for postoperative relapse remaining a central focus in clinical research. Pathological characteristics have been extensively investigated, with numerous studies confirming that high-grade histopathological subtypes, visceral pleural invasion, vascular invasion, and spread through air spaces constitute well-established high-risk factors for tumor recurrence and metastasis. In the era of rapidly advancing artificial intelligence, the development of risk prediction models facilitates precise identification of postoperative high-risk patients, thereby providing valuable guidance for adjuvant therapy strategies and follow-up management. This review systematically examines the high-risk pathological features associated with postoperative recurrence in early-stage lung cancer and evaluates current advancements in constructing risk prediction models based on pathological characteristics.