Non-small cell lung cancer (NSCLC), representing the predominant form of lung cancer globally, is frequently diagnosed at advanced stages. Conventional therapies including surgery, radiotherapy, and chemotherapy demonstrate limited efficacy in advanced disease. With advances in immunotherapy, immune checkpoint inhibitors (ICIs) have been established as first-line or second-line treatments for advanced NSCLC. However, ICI-related pneumonitis, occurring in approximately 5%~10% of patients, constitutes a potentially severe adverse reaction. A systematic review was conducted on the correlation between the timing of immunotherapy for NSCLC and the occurrence of pneumonia, covering the pathogenesis, clinical management, prevention strategies, and future research directions of immunotherapy related pneumonia. The aim is to provide scientific guidance for clinical physicians in the application of immunotherapy and provide reference for subsequent research, ultimately achieving the treatment goal of maximizing efficacy and minimizing adverse reactions.