Severe atrophic gastritis is not cancer. Patients with atrophic gastritis refer to damage to the gastric mucosa, such as repeated stimulation by alcohol, spicy and irritating foods, resulting in gradual atrophy or even disappearance of glands within the mucosa and gradual thinning of the gastric mucosa, often accompanied by intestinal epithelial hyperplasia, inflammatory reaction, atypical hyperplasia and other manifestations. Patients with severe atrophic gastritis have almost complete atrophy and disappearance of the original glands in various parts of the gastric wall, with manifestations such as intestinal epithelial hyperplasia glands. Usually the patient can show symptoms such as pain and discomfort in the upper abdomen with significant acid reflux and belching, which are usually found during gastroscopy and pathological biopsy and can suggest the presence of severe atrophy of the gastric mucosa. The disease is a benign lesion, and if the atrophic glandular layer develops intestinal epithelial hyperplasia without timely treatment, some patients can gradually develop into gastric cancer. Therefore, patients presenting with severe atrophic gastritis often need to be treated aggressively to avoid further development of the disease and to avoid the development of gastric cancer. Treatment is usually required according to the patient’s clinical symptoms and a regular diet, avoiding spicy and stimulating foods and alcohol, etc., to improve gastric function and the state of the gastric mucosa, thus stimulating the secretory function. In addition, the gastric mucosa has a strong self-healing ability and can usually be better improved by avoiding further stimulation of pathogenic factors. Patients need to be monitored during treatment with repeated gastroscopy examinations targeting the gastric mucosa. In case of severe conditions such as severe atypical hyperplasia, patients need to undergo surgery as soon as possible to avoid the development of gastric cancer.