Objective To evaluate the use of magnifying endoscopy combined with narrow band im-aging (NBI) system in diagnosis of early gastric cancer. Methods From March 2008 to December in 2008, a total of 56 patients with suspected gastric mucosal lesions were enrolled in the study. The lesions were ob-served with magnifying endoscopy combined with NBI and indigo-earmine-chromoendoscopy, and the results were compared with pathologic diagnosis from targeted biopsies. Results Out of 56 patients, 16 were diag-nosed as early gastric cancer pathologically. The accordance rate with the pathological diagnosis, sensibility, specificity, false positive rate and false negative rate of the magnifying endoscopy combined with NBI system were 94.6% (53/56), 93. 8% (15/16), 95.0% (38/40), 5.0% (2/40) and 6. 3% (1/16), respec-tively; while those of chromoendoscopy were 91.1% (51/56), 87. 5% (14/16), 92. 5% (37/40), 7. 5% (3/40) and 12. 5% (2/16), respectively (P >0.05). There was no difference between NBI and chro-moendoscopy in regarding of observing pit pattern, however, NBI was superior in displaying intrapapillary capillary loop. Conclusion Combination of magnifying endoscopy and NBI provides clear images of gas-tric mucosa and intrapapillary capillary, which is useful in diagnosis of early gastric cancer and can improve accuracy of biopsy. When combined with chromoendoscopy, it can further improve the yield of diagnosis.