Objective To investigate the morphologic features of gastric intestinal metaplasia (IM)using narrow band imaging(NBI)endoscopy,and its feasibility and accuracy for diagnosis of IM combined with histopathology.Methods The endoscopic examination was performed on 80 patients and suspected lesions associated with IM was further observed by NBI combined with magnifying endoscopy.The biopsy specimens were obtained from regions containing light blue crest(LBC)or non-LBC mucosa for pathological examination,and the results were analyzed.Results In 80 patients examined with NBI,IM was pathologically confirmed in 65 patients.Of which LBC was seen in 61 patients with a sensitivity of 94%and a specificity of 95%.In a total of 94 specimens obtained from LBC region,86 had histological evidence of IM with a positive predictive value of 9 1.49%.There was no evidence of IM in 79 out of 94 specimens obtained from non-LBC region of patients with or without LBC with a negative predictive value of 84.04%.The results indicated that the detective rate of IM could be increased if biopsy specimen was obtained from LBC region with help of NBI endoscopy(P＜0.05).Conclusions It has been demonstrated that NBI combined with magnifying endoscopy may improve the diagnosis of IM by clearly observing microvasculature and targeted-biopsy in LBC region,which is helpful in early diagnosis of gastric cancer.