Objective <p>This study investigated the possible mechanisms by which ropivacaine influences the progression of non-small cell lung cancer (NSCLC).</p> Methods <p>Plasmid vectors or oligonucleotides interfering with circ_0001320 or miR-518a-5p were transfected into ropivacaine-treated NSCLC cells, and circ_0001320 and miR-518a-5p levels were detected by RT-qPCR. Cell proliferation was assessed using CCK-8, apoptosis via flow cytometry, and cell migration and invasion through Transwell assays. Finally, the binding sites of circ_0001320 and miR-518a-5p were verified by the bioinformatics website CircInteractome and dual luciferase reporter gene assay.</p> Results <p>Exposure to ropivacaine resulted in the suppression of NSCLC cell proliferation, migration, invasion, and angiogenesis, while inducing apoptosis. Ropivacaine elevated circ_0001320 expression. Circ_0001320 downregulation resulted in a reduced efficacy of ropivacaine in inhibiting NSCLC progression. Interestingly, circ_0001320 targeted miR-518a-5p and inhibited its expression. It was possible to limit the effects of downregulation of circ_0001320 on NSCLC progression by downregulating miR-518a-5p.</p> Conclusion <p>Ropivacaine inhibits NSCLC progression via the circ_0001320/miR-518a-5p axis.</p>