Background: Endoscopic mucosal resection (EMR) is a treatment option for early gastric cancer with minimal risk of lymph node metastasis. Precut around a lesion during EMR facilitate en bloc resection which is an important determinant for complete resection of the tumor. We evaluated the efficacy and safety of EMR using precut and cut method (EMR-P) in relation to endoscopist's experience. Methods: We describe the experience of 60 consecutive early gastric cancer cases which are treated by EMR-P method performed by one endoscopist from January, 2002 to September, 2003. After submucosal injection of 0.25% sodium hyaluronate solution, precut was performed around the lesion with conventional needle knife, and then, resection was performed using direct snaring without exfoliation. The en bloc resection rate, complete resection rate, procedure time, and associated complications were compared between the first 30 cases and the subsequent 30 cases. Results: The en bloc resection rate and the complete resection rate in the whole series were 70% (42/60) and 72% (43/60), respectively. The en bloc resection rate in the first 30 cases was 53% (16/30) and that in the second 30 cases was 87% (26/30) (p=0.010). The complete resection rate in the first half was 60% (18/30) and that in the second half was 83% (25/30) (p=0.084). Residual tumors were found in 7 cases (12%) at follow-up biopsy, 3 in the first half and 4 in the second half. The mean procedure time of the first half was 27.0±11.4 min and that of the second half was 20.1±8.2 min (p=0.01). The mean size of the tumor and that of the resection specimen were not significantly different between the first half and the second half (9.9±7.3 vs. 10.4±4.1 mm, 26.1±7.5 vs. 27.1±6.9 mm, respectively). Perforation occurred in 3 cases in the first half and in 1 case in the second half. Delayed bleeding that required additional endoscopic treatment occurred in 1 case in each group. Conclusions: EMR-P method is an effective treatment option for early gastric cancer. However, learning curve of about 30 cases might be required to perform efficient and safe EMR-P for early gastric cancer treatment.