Objective:To investigate the clinicopathological factors predictive of lymph node metastasis (LNM) in undifferentiat-ed early gastric cancer (EGC) and to expand the possibility of endoscopic therapy for treating undifferentiated EGC.Methods:The re-searchers collected the data of 90 undifferentiated EGC patients who had undergone surgery at the Xingtai People's Hospital, Xingtai, China. The relationship between LNM and clinicopathological factors was retrospectively analyzed using univariate and multivariate lo-gistic regression analyses. Results:Univariate analysis showed that tumor size, lymphatic vessel involvement (LVI), and cancer inva-sion depth were the significant and independent risk factors for LNM. The LNM rate was 57.1%in patients with the three clinicopatho-logical risk factors. LNM was not found in patients without the three risk factors. Conclusion:Tumor size, LVI, and invasion depth are independently associated with the presence of LNM in undifferentiated EGC. Endoscopic therapy can be used to treat the patients with-out risk factors.