Background: The effect of tumor size on the prognosis of node-negative non-small-cell lung cancer (NSCLC) might be biased by missed lymph node metastasis and local disease extension. Methods: We investigated 2,260 patients with N0M0 NSCLC in the Surveillance, Epidemiology and End Results (SEER) database diagnosed from 1998 to 2012. Eligible patients had >= 18 lymph nodes examined and no disease extension. Tumor size was classified as T1a (0-10 mm), T1b (11-20 mm), T1c (21-30 mm), T2a (31-40 mm), T2b (41-50 mm), T3 (51-70 mm), and T4 (>70 mm). Results: The 5-year cancer-specific survival (CSS) rates for T1a, T1b, T1c, T2a, T2b, T3, and T4 patients were 85.6%, 84.4%, 79.9%, 77.9%, 70.0%, 63.0%, and 61.7%, respectively. The 5-year overall survival (OS) rates for T1a, T1b, T1c, T2a, T2b, T3, and T4 patients were 77.8%, 74.1%, 68.2%, 64.5%, 58.7%, 53.2%, and 57.3%, respectively. Using T1a as the reference, the hazard ratio generally increased with tumor size in the multivariate analysis of CSS and OS, with the exception of T4 patients. Conclusion: After adjusting for lymph node examination and disease extension, tumor size still had a significant effect on CSS in NSCLC, although the effect seemed to be smaller than that in a more generalized population.