【Abstract】 Objective To analyze the effect of endoscopic mucosal decollement on the clinical efficacy, recurrence rate and complications of patients with early gastric cancer. Methods 55 patients with early gastric cancer admitted to our hospital from January 2018 to September 2018 were enrolled in the study group, including 27 patients in the study group and 28 patients in the control group. The control group was treated with surgery. The patients in the study group were treated with endoscopic mucosal decollement. The clinical efficacy of patients, the recurrence rate after treatment, and the incidence of complications in the two methods were compared. Results There was no significant difference in clinical efficacy between the control group and the study group (96.43% vs 96.30%) (P＞0.05). The operation time of the study group was longer than that of the control group, while the operation time, intraoperative blood loss, hospitalization time, and total expenses in the study group were significantly less than those of the control group. The postoperative gastric emptying time, gastrointestinal ventilation time, and analgesic use within 24 hours after surgery were significantly better than those of the control group (P＜0.05). The incidence of postoperative complications in the control group was significantly higher than that in the study group (28.57% vs 7.40%) (P＜0.05). After followup in 1 year. There was no significant difference in the recurrence rate between the study group and the control group (3.70% vs 3.57%)(P＜0.05). Conclusion Endoscopic mucosal decollement can effectively treat patients with early gastric cancer, reduce intraoperative blood loss, shorten gastrointestinal recovery time and treatment duration, and improve the clinical efficacy of patients.