Objective: To develop and validate a simple clinical risk scoring system for postoperative complications in patients undergoing thoracoscopic lung cancer surgery. Methods: Data were collected from 165 patients who underwent thoracoscopic lung cancer surgery at our hospital between January 2023 and December 2024, with postoperative composite complications as the primary outcome measure. Single-factor and multivariate logistic regression analyses were performed to identify independent risk factors for postoperative complications. A nomogram model was constructed, and its performance was validated using ROC curves, the Hosmer-Lemeshow (H-L) goodness-of-fit test, and decision curve analysis. Results: The incidence of postoperative composite complications was 25.45% (42/165). Results of multivariate logistic regression analysis showed that concomitant cerebrovascular disease (P=0.003) and increased total intraoperative fluid intake (P=0.005) were independent risk factors; elevated preoperative low-density lipoprotein cholesterol (LDL-C) levels (P<0.001) and elevated preoperative fibrinogen (Fib) levels (P=0.004) were independent protective factors. The model’s AUC was 0.81; the P-value for the H-L test was 0.2766, indicating good model calibration; and the DCA confirmed that the model yields a clinical net benefit. Conclusion: Cerebrovascular disease, total intraoperative fluid intake, and elevated preoperative LDL-C and fibrinogen levels are independent risk factors for postoperative complications. A simple clinical risk scoring system based on these indicators demonstrates good discriminatory power, calibration, and clinical utility.