Thymoma is often accompanied by myasthenia gravis (MG), and the resection of thymoma improves myasthenic symptoms in patients with thymoma and MG (TMG), but some patients still have no relief. Through proteomic analysis, we examined preoperative serum samples from patients with TMG to identify key prognostic proteins that could serve as a foundation for clinically predicting postoperative efficacy and guiding treatment selection.