Background <p>This study aimed to evaluate the prognostic factors influencing survival in patients who underwent surgical treatment for early-stage non-small cell lung cancer (NSCLC) and were found to have N1 lymph node metastasis on pathological examination.</p> Methods <p>A total of 66 NSCLC patients who underwent anatomic lung resection (lobectomy, bilobectomy, or pneumonectomy) at our clinic between 2010 and 2020 and had a pathological stage of T1–2N1M0 disease were retrospectively analyzed. Clinical, demographic, histopathological, and surgical data, as well as survival times, were evaluated. Survival analyses were performed via the Kaplan–Meier method, and prognostic variables were assessed via univariate and multivariate analyses.</p> Results <p>A total of 66 patients, 60 males and 6 females, were included in the study. The mean age was 63.7 ± 8.3 years. The mean overall survival was 59.7 months, and the disease-free survival was 52.0 months. Squamous cell carcinoma histology, central tumor location, the presence of occult lymph node metastasis, and visceral pleural invasion were significantly associated with survival (<i>p</i> &lt; 0.05). Cox regression analysis revealed that the histological subtype and the visibility of N1 metastasis were identified as independent prognostic factors.</p> Conclusion <p>Pathological N1 lymph node involvement has a significant effect on the prognosis of patients with NSCLC. In particular, histological subtype and the presence of occult metastasis are key determinants of survival.</p>