We aim to comprehensively assess the prognostic performance of AFR and FA scores in patients with lung cancer (LC).We conducted a comprehensive search of PubMed, Web of Science, and CNKI databases to identify relevant studies. The primary endpoints assessed were overall survival (OS) and progression-free survival (PFS). Integrated hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated through pooling analysis.A total of 3145 participants from 10 studies were included in the analysis. In LC patients, the pooled results showed that low AFR predicted a worse outcome for OS (HR 1.76, 95% CI 1.51-2.06, p < 0.001) and PFS (HR 1.50, 95% CI 1.29-1.74, p < 0.001), and high FA score was associated with worse OS (HR 2.61, 95% CI 1.75-3.90, p < 0.001) and PFS (HR 2.38, 95% CI 1.60-3.55, p < 0.001).This meta-analysis demonstrated that a low AFR and a high FA score were associated with an increased risk of mortality and disease progression in LC, suggesting their potential as prognostic biomarkers.© 2025 Royal Australasian College of Surgeons.