【Abstract】Objective To develop a nomogram for predicting lymph node metastasis in early gastric cancer (EGC) to avoid unnecessary gastrectomy. Methods This study retrospectively analyzed the clinicopathological data of 332 patients with EGC who underwent gastrectomy. Among them, 236 cases were included in the training cohort and 96 cases were included in the independent validation cohort. Significant risk factors in univariate analysis were further identified as independent variables in multivariate logistic regression analysis, and then they were incorporated and expressed in nomograms. And draw internal and external verification curves to evaluate the distinguishability of the nomogram. Use receiver operating characteristic curve (ROC) to evaluate the predictive value of the model. Results Multivariate analysis showed that age, tumor size, depth of invasion, vascular invasion and histologic differentiation are important prognostic factors affecting lymph node metastasis. The nomogram has good distinguishability, and the consistency index is 0863. This was supported by the external validation point of 0867. Conclusion We have developed and validated a nomogram to predict the risk of lymph node metastasis in patients with EGC. This precise nomogram can identify EGC patients with a high probability of lymph node metastasis, and help avoid unnecessary gastrectomy after endoscopic resection.