〔Abstract〕 Objective To investigate the efficacy of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection in the treatment of early gastric cancer. Methods A total of 66 patients with early gastric cancer treated in the Department of Gastrointestinal Surgery of the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to January 2020 were selected. According to the random coin flipping method, they were divided into an observation group and a control group, with 33 cases in each group. The control group was treated with open distal gastric cancer surgery combined with D2 lymph node dissection, and the observation group was treated with minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection. The study was observed for 1 year and followed up for 2 years. Operation related indicators, lymphatic clearance, postoperative complications and recurrence at different postoperative periods were compared between the two groups. Results In the perioperative period, the amount of surgical bleeding, operative time, postoperative exhaust time, postoperative hospital stay and total incidence of complications in the observation group were lower than those in the control group, with statistically significant differences (P < 0.05). There was no statistically significant difference in lymphatic clearance between the two groups (P > 0.05). There was no significant difference in recurrence rate between the observation group and the control group at different time after surgery (P > 0.05). Conclusion Minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection in the treatment of early gastric cancer has low of surgical trauma, fast postoperative recovery, reduced complications and shortened postoperative hospital stay.