Non-small cell lung cancer, characterized by high incidence and mortality rates, significantly threatens human health. Precisely assessing patient prognosis and implementing adaptive treatment strategies have emerged as pivotal issues in contemporary thoracic oncology. Postoperative minimal residual disease (MRD) detection through liquid biopsy has demonstrated substantial potential. Circulating tumor DNA (ctDNA) enables real-time dynamic monitoring of tumor alterations. With advancements in ctDNA detection technologies, ctDNA has become a core method for MRD assessment. In the context of postoperative surveillance, ctDNA detection facilitates more accurate prognostic stratification and early prediction of tumor recurrence. Regarding therapeutic interventions, ctDNA detection can predict the efficacy of neoadjuvant and adjuvant therapies. In the future, further elucidating the value of assessing ctDNA status in predicting patient prognosis and guiding drug therapies will contribute to the advancement of precision medicine and adaptive treatments.