Chronic atrophic gastritis is the most serious type of chronic gastritis, especially when chronic atrophic gastritis develops heterogeneous hyperplasia, which is called precancerous lesion of gastric cancer and is very serious. If the heterogeneous hyperplasia is only mild or moderate, also known as mild to moderate atypical hyperplasia, it may be reversed with active treatment. Once severe atypical hyperplasia occurs, it is considered as precancerous lesion of gastric cancer and requires prophylactic surgical treatment, usually mucosal resection. If chronic atrophic gastritis with heterogeneous hyperplasia is clearly identified by electronic gastroscopy plus pathological examination, active treatment should be provided in cooperation with doctors and preventive surgery should be performed if necessary.