【Abstract】 Objective To explore the clinical effect of presmall incision in laparoscopyassisted radical gastrectomy for distal gastric cancer. Methods The clinical data of 156 patients with distal gastric cancer were collected from Sichuan Province People's Hospital from July 2014 to April 2017. Among them, 50 patients with presmall incision laparoscopicassisted surgery were enrolled in presmall incision group, 48 patients with totally laparoscopic surgery in total laparoscopy group and 58 patients with open abdominal in open surgery group. The age, BMI, tumor diameter, gender, preoperative anesthesia ASA classification, anastomosis, TNM staging, preoperative complications, surgical incision length, operation time, cleaning No.4d, 5,6,7,8, 12 groups of lymph node time and blood loss, intraoperative blood loss, number of intraoperative lymph node dissections, first discharge time, postoperative bedtime, postoperative 24hour and 72hour pain scores, number of postoperative pain medications, postoperative Hospitalization time, postoperative complications, and clinical efficacy of the three groups were analyzed. Results The incision length in the presmall incision group was significantly shorter than that in the open abdominal group, but longer than that in total laparoscopy group (P＜005). In the presmall incision group, the operation time, the time and the amount of blood loss for lymph node dissection of No. 4d, 5, 6, 7, 8, 12 were less than those in the total laparoscopy group (P＜005), but no significant difference compared with the open surgry group,(P＞005). There were statistically significant difference in bleeding amount during surgery, anus exhaust time，the postoperative ambulation time, the postoperative 24h、72h pain score, the frequency of using pain medication and postoperative hospital stay between the presmall incision group and open surgery group (P＜005), but no significant difference compared with the total laparoscopy group(P＞005).Conclusion The presmall incisionassisted laparoscopic radical gastrectomy has been proved to be a safe and timesaving procedure with small amount of blood loss and short learning curve and is worth to be popularized.