Because of the limitations of therapeutic approaches, patients suffering from lung adenocarcinoma (LUAD) have unsatisfactory prognoses. Studies have shown that neurotransmitters participated in tumorigenesis and development. In LUAD, the expression of neurotransmitter release cycle-related genes (NRCRGs) has been reported to be disordered. This study aimed to study the correlation between NRCRGs and LUAD. In this study, based on the Cancer Genome Atlas cohort, consensus clustering analyses were performed on ten neurotransmitter release cycle-related (NRCR) differentially expressed genes. Neurotransmitter release cycle (NRC) scores were derived by the Least Absolute Shrinkage and Selection Operator-Cox regression model constituted by 3 NRCRGs. Univariate and multivariate Cox regression analyses were performed to evaluate the prognosis value of the NRC score. In addition, single-Sample Gene Set Enrichment Analysis and CIBERSORT were conducted in the Cancer Genome Atlas cohort. Finally, gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses were also performed. As a result, the NRC-low group showed a good prognosis instead of the NRC-high group. NRC score was identified to be an independent prognosis factor for LUAD. In general, the NRC score based on the prognostic model was found to be closely correlated with immunotherapyrelated anti-cancer immunity and inflamed tumor microenvironment. Functional enrichment results demonstrated that differentially expressed genes between 2 NRC groups were closely correlated with DNA replication, cell-substrate adhesion, Golgi vesicle transport, MAPK signal pathway, and many others. Novel biomarkers were offered for predicting the prognoses of LUAD patients. The NRC score might contribute to guiding LUAD patients with immunotherapy selection.Abbreviations: APM = antigen processing machinery, AUC = area under curve, DEGs = differentially expressed genes, EMT = epithelial to mesenchymal transition, FDR = false discovery rate, GEO = the Gene Expression Omnibus, GO = gene ontology, ICPGs = immune checkpoint genes, ICPs = immune checkpoints, ICR = immunologic constant of rejection, KEGG = Kyoto Encyclopedia of Genes and Genomes, LASSO = the Least Absolute Shrinkage and Selection Operator, LUAD = Lung adenocarcinoma, M3R = muscarinic receptors, NRC = neurotransmitter release cycle, NRCR = neurotransmitter release cyclerelated, NRCRGs = neurotransmitter release cycle-related genes, NSCLC = non-small cell lung cancer, NTRs = neurotransmitter receptors, OSs = overall survivals, TCGA = The Cancer Genome Atlas, TME = tumor microenvironment.