Endoscopic submucosal dissection (ESD) for the treatment of early gastric cancer (EGC) has been accepted by many gastroenterologists, and ESD has been gradually popularized in china.Under the guidance of various endoscopic experts, through the continuous learning of domestic endoscopic doctors, the diagnosis of early gastric cancer, indications of ESD treatment, intraoperative operation, postoperative pathology, postoperative follow-up and treatment are gradually standardized. With the increase of ESD treatment cases of early gastric cancer, endoscopic doctors will face more and more cases of cases which is out of indication, and how to deal with them properly is a must. This article makes some discussions about this.