Objective:To compare the follow-up survival rate and recurrence rate of EGCs gastric cancer patients receiving ESD and surgery. Methods: A total of 90 patients with gastric cancer with EGCs admitted to our hospital from April 2020 to January 2022 were opted and randomly divided into two clusters, 40 situations in the control cluster and 50 situations in the study cluster. The control cluster received traditional surgical healing, and the study cluster received ESD healing. The variations in surgical indicators, immune indicators, complications, life, and follow-up survival and recurrence rates were Contrasted between the two clusters after healing with different methods. Results: Contrasted with the control cluster, the length of incision, operation and hospital stay in the study cluster were shorter, and the amount of intraoperative blood loss was bottom (P<0.05). None notable variation in immune indexes between the two clusters before surgery (P>0.05). The levels of TNF-α, IL-6 and CRP in the cluster were bottom (P＜0.05); Contrasted with the control cluster, the incidence of complications in the study cluster was bottom (P＜0.05); None notable variation in the life between the two clusters before surgery (P＞0.05). , Contrasted with the control cluster after operation, the SF-36 mark of the study cluster was upper (P<0.05); None notable variation in the survival rate and recurrence rate within 1-5 years between the two clusters (P>0.05). Conclusion: After ESD and surgical healing of EGCs gastric cancer, the survival rate of patients was upper, and the recurrence rate was bottom. None notable variation in the long-term prognosis between the two methods. However, ESD is a minimally invasive healing, which has the advantages of short incision, low bleeding and small trauma, and has little impact on the immune function of the body. It can effectively reduce the occurrence of postoperative complications, shorten the hospital stay and improve the life. Therefore, for patients who meet the conditions, ESD can be preferred for the healing of EGCs gastric cancer.