Minimally invasive surgery has become the preferred treatment strategy for most gastrointestinal diseases. Owing to specific anatomical reasons and in highly selected patients, gastric diseases offer the opportunity for an endogastric approach. In this setting, 2 different strategies may be used: (1) endogastric mucosectomy for superficial lesions such as highly selected early gastric cancer and (2) stapled wedge resection for intramural lesions such as gastric stromal tumors. A detailed description of this simple and radical treatment option is performed which requires standard laparoscopic instrumentation and basic laparoscopic skills. With the widespread of this approach, endogastric surgery is expected to become the preferred initial step in the management of various gastric diseases.