In the past few years, the early detection of gastric cancer has increased in China. The surgical treatment for early gastric cancer has gradually transformed from conventional gastrectomy with D2 lymphadenectomy to function-preserving gastrectomy which maximally preserves the anatomy and physiology of stomach to maintain the quality of life of the patient. Driven by minimally invasive techniques, function-preserving gastrectomies, including pylorus-preserving gastrectomy, proximal gastrectomy, sentinel node navigation surgery, etc. have already gained great attention especially in Japan and Korea. Although there are still many unsolved problems that need to be further discussed and explored, understanding of the clinical features of early gastric cancer and definition of gastric function preservation, launching clinical trials for solving practical problems, and emphasis of individualized and precision treatment will be the best strategies to improve the efficacy of early gastric cancer.