Tyrosine kinase inhibitors (TKIs) provide clinical benefits to the lung cancer patients with epidermal growth factor receptor (EGFR) mutations. However, non-invasively determine EGFR mutation status in patients before targeted therapy remains a challenge. This study aimed to develop and validate a nomogram for preoperative prediction of EGFR mutation status in patients with lung adenocarcinoma. The medical records of 403 patients with lung adenocarcinoma confirmed by histology from January 2016 to June 2020 were retrospectively collected. We combined CT features and clinical risk factors and used them to build a prediction nomogram. The performance of the nomogram was evaluated in terms of calibration, discrimination, and clinical usefulness. The nomogram was further validated in an independent external cohort. Finally, a nomogram that contained CT features and clinical risk factors, which could conveniently and non-invasively predict EGFR mutation status in patients with lung adenocarcinoma before surgery.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.