ObjectiveTo evaluate the diagnostic value of VS classification of magnifying endoscopy with blue laser imaging （ME-BLI） for gastric precancerous lesion and early gastric cancer. MethodsA retrospective study was performed on the data of 313 patients （322 lesions） with gastric mucosal lesions undergoing ME-BLI in digestive endoscopy center of Renmin Hospital of Wuhan University from January 2014 to January 2017. The accuracy， sensitivity， specificity， positive predictive value and negative predictive value of VS classification by ME-BLI in diagnosis of gastric precancerous lesion and early cancer were analyzed. ResultsAmong the 322 lesions， 57 were pathologically diagnosed as cancerous lesions and 265 were non-cancerous lesions. According to VS classification of ME-BLI， 98.2％ （56／57） VS structures of the cancerous lesions were irregular or disappearing， and 100.0％ （57／57） cancerous lesions had clear demarcation. Taking the pathological diagnosis as the gold standard， the accuracy of VS classification of ME-BLI was 93.8％ （302／322）， with a good consistency with pathological diagnosis（Kappa=0.810）. The sensitivity， specificity， positive predictive value， and negative predictive value were 98.2％ （56／57）， 92.8％ （246／265）， 74.7％ （56／75） and 99.6％ （246／247）， respectively. ConclusionThe VS classification of ME-BLI is an effective method with high accuracy， sensitivity and specificity for diagnosis of gastric precancerous lesion and early gastric cancer.