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Objective: To investigate the clinical effect of endoscopic submucosal dissection (ESD) on the treatment of gastrointestinal carcinoma in early stage and precancerous lesions. Methods: 79 patients with gastrointestinal carcinoma who were treated in our hospital from August 2013 to August 2014 were selected as the research subjects. According to the different operation methods, the selected patients were divided into the ESD group (49 cases) and the control group (30 cases). The patients in ESD group were treated with endoscopic submucosal dissection, and the patients in the control group were treated with conventional surgery. Then the operation time, curative resection rate, the whole complete resection rate, postoperative complication and recurrence and metastasis in the two groups were observed and compared. Results: The operation time in the ESD group was less than that of the control group, and the difference was statistically significant (p<0.05); The curative resection rate in the two groups were 100%, and there was no statistically significant difference (P>0.05); The whole complete resection rate in the ESD group was 63.27% which was lower than 86.67% of the control group, and the difference was statistically significant (p<0.05). The incidence of postoperative complications in the ESD group was 4.08% which was lower than 13.3% in the control group, and the difference was statistically significant (P<0.05). There was no metastasis and recurrence of primary lesions in the two groups after the operation for one year. Conclusion: The clinical effect of ESD on the treatment of gastrointestinal carcinoma and precancerous lesion is better. Compared with the conventional operation, ESD has less complications and higher safety, which is more suitable for clinical application. [ABSTRACT FROM AUTHOR]