〔Abstract〕 Objective To investigate the efficacy and safety of endoscopic submucosal dissection (ESD) in the treatment of early signet-ring cell carcinoma of the stomach. Methods The clinical data of 21 patients with early signed-ring cell carcinoma of the stomach diagnosed by endoscopy in South Hospital of Fujian Provincial Hospital from July 2016 to December 2016 were retrospectively analyzed. Among them, 10 patients received ESD treatment (endoscopic treatment group) and 11 patients received surgical treatment (surgical treatment group). The incidence of complications, en bloc resection and complete resection were observed in the endoscopic treatment group, and the differences in gender, age, tumor lesion size, postoperative hospital stay and depth of pathological invasion were compared between the two groups. The efficacy and safety of ESD in the treatment of early signet ring cell carcinoma of the stomach were summarized. Results All patients in the endoscopic treatment group achieved complete resection after treatment, and no complications such as bleeding or perforation occurred. There was no significant difference in gender composition, age, tumor lesion size, and depth of postoperative pathological invasion between the two groups (P > 0.05). In terms of postoperative hospital stay, the endoscopic treatment group was shorter than that of the surgical group, and the difference was statistically significant (P < 0.05). Conclusion For early signet ring cell carcinoma of the stomach, ESD has a good effect similar to surgery, and the length of hospital stay after ESD is even shorter. However, the boundary of lesions and indications should be strictly evaluated before ESD.