With the continuous development of endoscopic equipment and operation technology, endoscopy has become an important method for the treatment of early gastric cancer. Early detection of tumor lesions and resection through endoscopy has become the ideal goal for the treatment of gastrointestinal tumors. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissecfion (ESD) are the most commonly used endoscopic treatment methods for early gastric cancer, and other endoscopic laser therapy, microwave therapy, photodynamic therapy and argon ion plasmapheresis (ARP) are also available. However, since the latter cannot obtain pathological specimens of intact lesions, the clinical application is greatly limited. EMR for early gastric cancer was first used in Japan and is now widely used in Japan. Before the introduction of endoscopic mucosal resection in Japan, gastrectomy was the only treatment method for early gastric cancer. The advantage of this technique is that it only requires the use of a general gastroscope and no special equipment, but the disadvantage is that the technique cannot remove large lesions in their entirety, and it is difficult to perform detailed pathological analysis on the removed fragmented specimens. There is a high risk of tumor recurrence. ESD is an endoscopic technique that uses a modified needle knife to peel the mucosa directly from the submucosa and is the most commonly used method for resection of large lesions in Japan and in other countries. With the continuous improvement of endoscopic treatment methods, the indications for endoscopic treatment of early gastric cancer are also changing. At present, scholars basically agree that early gastric cancer without lymph node metastasis is an indication for endoscopic treatment. Soetikno et al. suggested that the indications for EMR are cases with little possibility of lymph node metastasis and complete resection of the lesion, including: (1) lesions < 2 cm in diameter with endoscopic diagnosis of intramucosal carcinoma; (2) highly differentiated carcinoma; and (3) depressed lesions without ulceration on the surface. The indications for ESD include: (1) differentiated intramucosal carcinoma of any size without ulcer formation; (2) differentiated intramucosal carcinoma with ulcer formation, the lesion diameter should be < 3 cm; (3) undifferentiated intramucosal carcinoma without ulcer formation, the lesion diameter should be < 2 cm; (4) differentiated submucosal microcarcinoma with diameter < 3 cm without ulcer formation and without vascular (lymphatic) infiltration. However, there are problems with endoscopic treatment of early gastric cancer: (1) how to accurately determine the possibility of lymph node metastasis before surgery; (2) whether endoscopic treatment is really better than surgical treatment; (3) the different criteria for judging early cancer in western countries and Japan, as severe atypical hyperplasia diagnosed in western countries is often diagnosed as early gastric cancer by Japanese pathologists, therefore, the long-term effect of endoscopic treatment of early gastric cancer, and the long-term effect of endoscopic treatment of early gastric cancer that meets our diagnostic criteria. and the prognosis of endoscopic treatment of early gastric cancer meeting the diagnostic criteria in China need to be further studied.