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In low-dose computed tomography (LDCT), lung segmentation effectively improves the accuracy of lung cancer diagnosis. However, excessive noise is inevitable in LDCT, which can decrease lung segmentation accuracy. To address this problem, it is necessary to derive an optimized kernel size when using the median modified Wiener filter (MMWF) for noise reduction. Incorrect application of the kernel size can result in inadequate noise removal or blurring, degrading segmentation accuracy. Therefore, various kernel sizes of the MMWF were applied in this study, followed by region-growing-based segmentation and quantitative evaluation. In addition to evaluating the segmentation performance, we conducted a similarity assessment. Our results indicate that the greatest improvement in segmentation performance and similarity was at a kernel size 5 × 5. Compared with the noisy image, the accuracy, F1-score, intersection over union, root mean square error, and peak signal-to-noise ratio using the optimized MMWF were improved by factors of 1.38, 33.20, 64.86, 7.82, and 1.30 times, respectively. In conclusion, we have demonstrated that by applying the MMWF with an appropriate kernel size, the optimization of noise and blur reduction can enhance segmentation performance.