Background: This study analyzed the application of dual bronchodilators in patients with non-small cell lung cancer (NSCLC) & chronic obstructive pulmonary disease (COPD) during the perioperative period. Research design and methods: A total of 100 patients with moderate to severe COPD who underwent thoracoscopic lobectomy were divided into two groups. The patients in the observation group (group O) were treated with umeclidinium/vilanterol and conventional treatment (oxygen therapy, assisted expectoration, respiratory rehabilitation training) during the perioperative period. The patients in the control group (group C) received conventional treatment. Lung function, arterial blood gas values, quality of life, postoperative adverse reactions, days of postoperative chest tube placement and hospitalization were assessed. Results: Before surgery, group O presented higher FEV1, FVC, PEF and MVV, elevated PO2 and reduced PCO2, lower CAT scores compared with the group C (p < 0.05). The group O demonstrated fewer perioperative adverse reactions, and shorter days of postoperative chest tube and hospitalization compared with the group C (p < 0.05). Conclusions: Perioperative inhalation of umeclidinium/vilanterol can effectively protect arterial blood gas and respiratory function in patients with LC complicated with COPD.