The postoperative complications occurred in a high ratio (41%) after total gastrectomy (TG) for stomach cancer. In order to decrease the complications, an ultrasubtotal gastrectomy (USG) was performed for cancers in the upper or middle stomach. Since 1989, twenty-eight patients with cancer in the middle or upper stomach have undergone an ultrasubtotal gastrectomy (USG). The cardia and the proximal 1/10 of the stomach were preserved, and D2 lymph node dissection was performed. Of those patients that underwent a USG, none died of postoperative complications (5.3% in TG : p <0.05), and neither anastomotic leakage nor gastrointestinal bleeding was observed (3.5% and 10.7%, respectively in TG : p< 0.05). The two year survival rate of patients that underwent USG was 46% (25% in TG : p <0.05). These results suggested that the USG is a safer surgery than a TG for patients with cancer in the upper or middle stomach, and the survival rate is improved when the USG is performed.