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Endoscopic mucosal resection for early gastric cancer is a widely accepted and practiced technique in countries such as Japan and China where the prevalence of gastric cancer is significantly higher than in the US. This review discusses standard endoscopic mucosal resection methods, as well as newly developed techniques. Data are reviewed in terms of complete resection rates and disease-free survival so as to allow endoscopists to determine which treatment options are best for their patients.Within the past few years, new endoscopic mucosal resection and submucosal dissection techniques have been developed. These techniques may allow for the treatment of lesions that are not suitable for endoscopic treatment, especially in high-risk patients.As gastroenterologists and surgeons in the West become more familiar and experienced with the techniques of endoscopic mucosal resection and submucosal dissection, patients will benefit from these minimally invasive therapeutic techniques. Although controlled studies are needed, in the future these methods may also be used to treat other early malignant conditions of the gastrointestinal tract.