Laparoscopic surgery for gastric cancer in Japan has been established as a treatment for early gastric cancer after technical improvements, development of instruments, and efforts of surgeons. The technigue was extended to some advanced gastric cancers and now plays an important role in the gastric cancer treatment strategy with open surgery and endoscopic mucosal resection. Laparoscopic surgery for early gastric cancer has been evaluated as less invasive, offering radical cure, and safe in several clinical trials and case-control studies. However, the accumulation of more cases and additional basic research are necessary before adapting laparoscopic surgery for advanced gastric cancer. A large-scale, randomized, controlled study will be carried out in early gastric cancer, and, as a result, scientific and objective evaluation of laparoscopic surgery for gastric cancer will be possible in the near future.