Laparoscopic-assisted proximal gastrectomy was performed in two Japanese patients with early gastric carcinomas located in the gastric cardia. The lower esophagus and upper stomach was divided under the pneumoperitoneum and resected via a minilaparotomy through an incision, 5 cm long, made in the epigastric area. The distal esophagus was anastomosed to a gastric tube made by resecting the lesser curvature of the stomach with a linear auto-stapler. Both patients recovered quickly without any postoperative complications, such as esophagitis, developing during follow-up periods of 3 and 6 months, respectively. Thus, we conclude that laparoscopic-assisted proximal gastrectomy and reconstruction with a gastric tube may be an effective method of treatment for patients with early gastric carcinomas located in the upper stomach in this era of minimally invasive surgery.