Objective To analyze interobserver variability in endoscopic diagnostic accuracy of chronic atrophic gastritis (CAG) among endoscopists with varying levels of experience. Methods Endoscopic examination data from 247 patients who underwent endoscopy from January 2021 to June 2024 at Department of Gastroenterology, the First Affiliated Hospital of Army Medical University (n=154), Renmin Hospital of Wuhan University (n=35) and Shanxi Provincial Coal Central Hospital (n=58) were retrospectively collected. The collected images were reviewed by an expert panel of three individuals with the title of deputy chief physician or above. The final endoscopic Kimura-Takemoto classification diagnosis of the expert panel was regarded as the golden standard. Fourteen endoscopists from the above three centers provided their Kimura-Takemoto classification diagnosis. These endoscopists were divided into the junior group (n=7, with experience of <2 000 procedures) and the senior group (n=7, with experience of >10 000 procedures). The difference in the accuracy of endoscopic Kimura-Takemoto classification diagnosis between the groups were analyzed. Results Diagnostic accuracy for Kimura-Takemoto classification ranged from 65.99% (163/247) to 86.64% (214/247) in the senior group with the overall accuracy of 77.27% (1 336/1 729). The junior group exhibited diagnostic accuracy ranging from 36.44% (90/247) to 72.47% (179/247) with the overall accuracy of 62.12% (1 074/1 729). The senior group demonstrated higher overall diagnostic accuracy than that of the junior group (χ2=93.27, P<0.001). The diagnostic accuracy of non-CAG in the senior group was higher than that in the junior group [83.73% (463/553) VS 72.33% (400/553), χ2=20.27, P<0.001]. The diagnostic accuracy of C-type atrophy in the senior group was higher than that in the junior group [90.10% (801/889) VS 82.79% (736/889), χ2=19.66, P<0.001] .The diagnostic accuracy of O-type atrophy in the senior group was higher than that in the junior group [83.97% (241/287) VS 68.29% (196/287), χ2=18.56, P<0.001]. Conclusion Interobserver variability is observed in the diagnostic accuracy of endoscopic Kimura-Takemoto classification for CAG among endoscopists with different experience levels. Experienced endoscopists exhibit higher diagnostic accuracy for CAG compared with their less experienced counterparts.