We have reviewed the clinicopathological features of submucosal gastric cancer with lymph node metastasis. The degree of vertical submucosal infiltration was classified into three stages as sm1, sm2 or sm3. The number of cases with lymph node metastasis of sm3 was significantly more than that of sm1 or sm2. We found no correlation between the tumor size and the rate of lymph node metastasis from submucosal invasive cancer. Accordingly, we concluded that the vertical submucosal infiltration was a more important factor for lymph node metastasis than horizontal infiltration. Minimal invasive surgery was recommended for a tumor measuring 1 cm or less in size with vertical submucosal invasion of sm1 or sm2.