Objective:To investigate the distribution patterns of TCM syndromes in low-grade gastric intraepithelial neoplasia (LGIN) and their correlation with microscopic endoscopic findings.Methods:A single-center cross-sectional study was conducted. Gastroscopic images of 254 patients with gastric LGIN admitted to Lu'an TCM Hospital from September 2020 to September 2024 were collected and classified according to TCM syndrome differentiation. The distribution characteristics of endoscopic findings in patients with different syndromes were observed from four aspects: mucosal color, Paris classification of lesions, lesion location, and accompanying microscopic findings. Apriori association rule analysis was performed to assess the correlation.Results:Among 254 patients with gastric LGIN, 64 cases were diagnosed with spleen-stomach deficiency, 33 cases with liver-stomach qi stagnation, 54 cases with liver-stomach heat stagnation, 40 cases with spleen-stomach damp-heat, 24 cases with gastric yin deficiency, and 39 cases with gastric collaterals stasis. Among these, mucosal red and white patches predominated with white, and vessels were visible. If accompanied by reduced or absent folds, flat erosion, or Grade Ⅱb, it was considered spleen-stomach deficiency; if accompanied by old hemorrhagic spots, rough mucosa, or granular nodular lesions, it was considered gastric vessel stasis; if mucosal swelling, elevated erosion, or Grade Ⅱa was accompanied by red and white patches with red predominating, it suggested liver-stomach heat stagnation; if accompanied by mottled mucosa, enlarged serpentine folds, and white turbid mucus, Ⅱa, it suggested spleen-stomach damp-heat. Mottled mucosa with bile reflux suggested liver-stomach qi stagnation. Depressed erosion with type Ⅱc suggested stomach yin deficiency.Conclusion:There is a certain correlation between different TCM syndromes and microscopic endoscopic findings in gastric LGIN, which can provide some references for clinical differential diagnosis and classification.