Gastric cancer remains one of the most common cancers worldwide. In Japan, about 57% of gastric cancers that currently treated are early gastric cancer (EGC), but in China, the percentage of EGC that are treated is only 10%. Minimally invasive approaches including endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are utilized for curative treatment of EGC and the patients obtained favorable prognosis. It is very important to follow the procedure of the EGC treatment. Firstly, examination of endoscopy, endoscopic ultrasonography and histology are crucial steps of selecting suitable patients for EMR/ESD. Secondly, carefully assessment of EMR/ESD specimens is a very important component to provide information for further surgical intervention, these information including lymph vascular tumor thrombus, tumor size, histological type, and the depth of invasion, Furthermore, lymphoid infiltration, presence of lymphatic invasion, and over-expression of HER2/neu, Mucin-4, VEGF C, VEGF D are associate with prognosis of EGC.