Abstract: The spread through air spaces (STAS) is one of the aggressive behaviors of lung adenocarcinoma. It is a risk factor for recurrence and an indicator of poor prognosis after sublobectomy. The association between computed tomography (CT)-based features and STAS can predict the STAS status of patients with lung adenocarcinoma, and thus, assist in the clinical selection of the appropriate type of surgery. This article reviewed the aggressiveness of STAS in lung adenocarcinoma and the current research on the preoperative CT prediction of STAS, as well as related new techniques.