Gastric dysplasia is considered to be the morphologic expression of the penultimate stage in gastric carcinogenesis. The clinical importance has been underscored until the close association with gastric cancer was established. Nevertheless, similar lesions are considered as high grade dysplasia by Western pathologists and as carcinoma by Japanese pathologists, using the Japanese group classification. Padova classification, Vienna classification and Vienna revisited, try to overcome these differences; because of this disagreement therapeutic guidelines are also controversial and differences in the incidence of early stages of gastric cancer and its outcome were reported.