Objective: To explore the prognostic factors of patients with Small Cell Lung Cancer (SCLC) treated with radiotherapy, chemotherapy combined with anlotinib, and to provide a basis for optimizing clinical treatment strategies. Methods: Sixty-four patients with small cell lung cancer admitted to Zhengzhou Central Hospital and Xinzheng Branch of Zhengzhou Central Hospital (Xinzheng Public People"s Hospital) from January 2021 to January 2024 were selected as the research subjects. All patients received radiotherapy and chemotherapy (etoposide + platinum + thoracic radiotherapy) combined with anlotinib treatment. Collect the baseline data of the patients; Statistically analyze the prognosis of the patients after treatment. The Progression-free survival (PFS) and Overall survival (OS) were analyzed by the Kaplan-Meier method. The Cox regression model was used to analyze the univariate and multivariate factors influencing the prognosis of patients. Results: The median PFS of the entire group was 7.65 months (95%CI: 6.42-8.88), and the median OS was 14.80 months (95%CI: 12.76-16.84). Univariate analysis showed that the Eastern Cooperative Oncology Group of the United States ECOG score ≥2 points (P=0.007), extensive stage (P=0.003), brain metastasis (P=0.011), Neuron-specific enolase (Neuron-specific enolase) NSE ≥35 ng/mL (P=0.002), NLR≥3.5 (P=0.018), anlotinib treatment <4 cycles (P<0.001), and non-PR /CR of therapeutic effect (P<0.001) were associated with a poorer prognosis. Multivariate analysis confirmed that ECOG score ≥2 points (HR=2.04, P=0.010), extensive stage (HR=2.15, P=0.009), brain metastasis (HR=1.85, P=0.027), and NSE≥35 ng/mL (HR=2.30) P=0.003), Neutrophil/lymphocyte ratio (NLR) ≥3.5 (HR=1.78, P=0.042), anlotinib treatment <4 cycles (HR=3.05) (P<0.001) and therapeutic effect non-PR /CR (HR=2.47, P=0.002) were independent risk factors for OS. Conclusion: ECOG score, clinical stage, brain metastasis, NSE level, NLR, anlotinib treatment cycle and efficacy are the key influencing factors for the prognosis of SCLC patients with radiotherapy and chemotherapy combined with anlotinib.