Based on inheriting Liu Jiaxiang’s academic thoughts of strengthening vital qi to treat cancer,combined with advances in modern oncology,the theories of tumor pathogenesis in traditional Chinese medicine are innovated,and the view that hidden toxicity due to vital qi deficiency as core pathogenesis of lung cancer onset and metastasis is proposed. It is considered that deficiency of vital qi is the fundamental factor of lung cancer onset,progression and rehabilitation,and the essence of deficiency of vital qi in lung cancer is systematically revealed from immunosenescence,immunoediting,immune-nerve-endocrine dysfunction and other aspects. The purpose of this paper is to deepen the understanding of lung cancer pathogenesis in traditional Chinese medicine,and further provide basis for comprehensive prevention and treatment of lung cancer with traditional Chinese medicine,and provide reference for prevention and treatment of other malignant tumors.