Endoscopic gastric mucosal resection (EGMR) is increasingly employed in early gastric cancer to remove the tumour with the surrounding mucosa and part of the submucosa after submucosal saline injection and staining to define the extent of the lesion. This study presents preliminary experience with a modified EGMR technique in five patients which allows more precise targeting and resection of the lesions. The time required for this procedure was less than 30 minutes in each case. All lesions were completely removed. In two patients, however, tumour growth invaded the submucosa and these patients therefore underwent subsequent surgery. Three patients with carcinoma confined to the mucosa were tumour-free at follow-up with repeat endoscopy and biopsy after 7 to 23 months.