Splenic hilar lymph nodes metastasis are prone to occurred in patients with middle-upper gastric cancer, therefore splenic hilar lymphadenectomy is recognized as an important part of the D2 lymph nodes dissection of gastric cancer. However, due to complicated distribution of splenic vessels, clinical application of spleen-preserving splenic hilar lymphadenectomy are limited. With the development of surgical equipment and technology, spleen-preserving splenic hilar lymphadenectomy is gradually recognized and applied. Laparoscopic pleen-preserving splenic hilar lymphadenectomy could achieve satisfactory clinical outcome in treating patients with gastric cancer, by appropriate surgical approaches and intraoperatie bleeding control, which might become one of the standard surgical methods of gastrectomy.