Objective To explore the effects of guided breathing training on the rehabilitation of older patients with lung cancer after thoracoscopic lobectomy. Methods A total of 78 older patients with lung cancer after thoracoscopic lobectomy were randomly assigned into the experimental group（40 cases） and the control group（38 cases）. Patients in the experimental group received guided breathing training,including intercostal muscle mobilization,rib mobilization,thoracic induction and abdominal breathing induction. Patients in the control group received routine pulmonary rehabilitation treatment. The pulmonary function before and 28 days after the operation,surgical complications,chest tube retention time and hospital stay were compared between the two groups. Results On the 28th day after operation,the peak expiratory velocity of the patients in the experimental group was（305±62） L/min while it was（223±42） L/min of patients in the control group（t=6.773,P<0.001）. The forced expiratory volume in one second in the experimental group was（1.8±0.4） L and it was（1.6±0.3） L of patients in the control group（t=2.799,P=0.006）. The combined incidence of postoperative pneumonia and atelectasis was lower in the experimental group（20.0%）than in the control group（44.7%）（χ²=11.744,P=0.001）. The length of indwelling chest tube in the experimental group was（80±31） h,and it was（97±36） h for patients in the control group（t=2.193,P=0.031）. The days of postoperative hospitalization in the experimental group were（4.2±1.5） d which were less than that of patients（5.1±1.4） d in the control group（t=2.764,P=0.007）. Conclusion Guided breathing training can improve lung function,reduce the incidence of atelectasis of pneumonia,shorten the time of retaining chest tube and hospital stay for elderly patients with lung cancer after thoracoscopic lobectomy.