The position paper recommends specific guidelines for surveillance of patients with atrophic gastritis, gastric intestinal metaplasia and dysplasia. Although gastric atrophy and intestinal metaplasia are recognized as premalignant conditions, there is insufficient data to recommend routine endoscopic surveillance. However, when endoscopy is performed, it should include topographic mapping for biopsies of the entire stomach, particularly the lesser curvature. Patients with confirmed high grade dysplasia should be considered for gastrectomy or local endoscopic resection because of high probability for development of adenocarcinoma.