Patients with early gastric cancer (EGC) have had a good prognosis with conventional gastrectomy and radical lymph node dissection. The conventional surgery revealed some kinds of early and late complications which may hurt patients seriously. Therefore, treatment options for EGC which preserve patients’ quality of life with maintaining a high level of curability have been developed. In surgeon’s field, these include limited gastrectomy with or without modified lymph node resection, gastrectomy with vagal nerve preservation, pylorus preserving gastrectomy, and laparoscopic gastrectomy. Laparoscopic gastrectomy has introduced a new concept of procedure in the treatment of EGC. Endoscopic mucosal resection (EMR) by endoscopist has also become a standard treatment option for EGC with limited indications. The development of endoscopic submucosal dissection (ESD) expanded the clinical relevance of EMR. Certain treatment options for EGC, such as laparoscopic surgery or EMR, are known to be good options for EGC treatment, but the long-term results should be confirmed by randomized prospective study before becoming standard treatments. At present. these less invasive treatment should be applied under the strict indications.