Total gastrectomy has been a standard treatment for upper-third early gastric cancer for decades. Supplementation is essential after total gastrectomy due to vitamin B12 deficiency. Additionally, postoperative complications, such as reflux esophagitis, anastomotic stricture, leakage, and malnutrition, are the main issues. Proximal gastrectomy is considered an alternative treatment for upper-third early gastric cancer. As a function-preserving gastrectomy it is known that the incidence of vitamin B12 deficiency is low and due to its various reconstruction methods we can easily overcome major postoperative complications. Therefore, we aimed to review about proximal gastrectomy, how it is reconstructed, and complications after reconstruction.