Two patients with early gastric carcinoma and who were poor surgical risks underwent gastrectomy following repeated laser endoscopy. Pathological findings of the resected stomach were reviewed. Lesions in both patients were ulcerative, with evidence of destruction of the muscularis mucosae caused by laser irradiation. Complete coagulation did not occur in the case of infiltrative-type involvement of the submucosal layer. Gastrectomy was carried out when the clinical status improved and both patients are now cancer-free. We propose that laser treatment for early gastric cancer should be considered for poor-risk patients.