Recently, with the advances in technique and equipment of endoscopy, it had offered much progress in the early detection and early therapy for gastric cancer. Clinically, as proposed by the Japanese Society of Gastroenterological Endoscopy in 1962, early gastric cancer (EGC) is defined as adenocarcinoma limited to the gastric mucosa and submucosa regardless of whether regional lymph nodes are involved or not. Early gastric cancer has obvious better prognosis than advanced gastric cancer. Cure rates achieved 95 percent if tumor limited to mucosal layer; 92 percent if tumor invades to muscle layer; and 23 percent if tumor invades to serosal layer. So early detection is the best and efficient way to improve whole survival. There existed some risk for complication and death in surgical resection of EGC. Then endoscopic therapy was generated for experienced and skilled gastroenterologist to perform the technique. It would be the first-line choice of management modality currently for early gastric cancer especially for the old-aged patients and patients who refused surgery. Endoscopic therapy could be divided into two types: one is local destruction, and the other is local resection. Nowadays endoscopic mucosal resection is the mainstay management for early gastric cancer. To date with statistics, it seemed acceptable about the prognosis and survival rate after EMR. However, it needs continuous follow-up to evaluate the long-term benefit after EMR.