Background: Methods: Our analysis included 23 patients with pathologically confirmed S/B-d NSCLC from January 2021 to December 2023. A retrospective analysis of clinical, serum tumor markers, imaging [including CT, FDG PET/CT, magnetic resonance imaging (MRI)], pathological features, treatment protocols, and follow-up results was performed. Independent samples Results: S/B-d NSCLC occurs predominantly in male patients with a history of smoking and a mean age of 62.78 years (39-77 years). S/B-d NSCLC was found incidentally during physical examination in 56.52% of patients. The CT scan features were as follows: predominantly tumors (72.73%), peripheral in the lungs (77.27%), round or roundish morphology (81.28%), pleural or vascular invasion (95.46%), and moderately to severely enhanced (59.09%). The FDG PET/CT showed FDG-avid with mean SUV Conclusions: S/B-d NSCLC has distinct features in epidemiology, serum tumor markers, imaging, and pathology. In particular, FDG-avid is evident in the FDG PET/CT scan. The size of the lesion and the degree of FDG avidity provide information about the degree of malignancy and the high probability of distant metastasis in S/B-d NSCLC. FDG PET/CT is recommended when S/B-d NSCLC is suspected based on CT features, especially for large lesions. The FDG PET/CT scan can help with accurate staging and individual treatment planning.