A 74-year-old man visited our hospital for follow-up esophagogastroduodenoscopy after eradication of Helicobacter pylori. Transnasal endoscopy (GIF-1200N with the EVIS X1 video system, Olympus Medical Systems, Tokyo, Japan) revealed a reddish lesion located in the anterior wall of the prepyloric region on white light imaging (Figure A) using indigo-carmine dye (Figure B). On texture and color enhancement imaging (TXI) mode 1 with indigo-carmine dye (chromo-TXI), the lesion was highlighted as being reddish and slightly depressed (Figure C). Endoscopic submucosal dissection was performed on the suspicion of a well-differentiated tubular adenocarcinoma for biopsy and endoscopic diagnosis. Histologic examination showed the lesion to be adenocarcinoma, well-differentiated, Paris type 0-IIc, measuring 5 × 5 mm, pT1a (M), no lymphovascular invasion (Figure D). TXI is a recently developed technique that enhances brightness, surface irregularities, and subtle color changes. Chromo-TXI facilitated the endoscopic diagnosis of early gastric cancer even with transnasal endoscopy, highlighting slightly depressed lesions, where reddish depressed lesions observed following H pylori eradication are often shown to be indistinguishable from gastric cancer lesions. Thus, chromo-TXI seems to be a more useful modality than white light imaging and may set a new standard for the detection of depressed early gastric cancer lesions.