Background: A major cause of cancer-related death is non-small-cell lung cancer (NSCLC). As only 20 % of NSCLC cases are typically discovered while the illness is potentially curable & resectable, resulting in poor 5-year survival rate. Objective: To compare between conventional versus VATS lobectomy in surgical treatment of NSCLC. Patients and Methods: This prospective randomized open label clinical trial involved 100 patients aged >18 years old sex diagnosed with NSCLS at Benha university. Randomly, cases were classified into 2 equal groups by computer generator into group A (n=50): underwent open thoracotomy, and group B (n=50): underwent VATS. All patients were subjected to full history taking, general examination such as vital signs and laboratory investigations were recorded. Results: Group A had significant increased duration of operation, prolonged air leak, & atelectasis than group B (P value <0.001, 027, 0.030 respectively). Pneumonia, hemothorax, AF, cerebrovascular accident and wound infection were insignificantly different between both groups. Group B had significant lower ICU stay & hospital stay than group A. Bleeding, readmission, recurrence, and mortality were insignificantly different between both groups. Group B had significant higher mean survival rate than group A. Conclusion: Open lobectomy was accompanied with a reduced survival rate and more comorbidities than VATS lobectomy. These findings imply showed that for treating NSCLC at an early stage, VATS is a safe & efficient method.