Laparoscopic gastrectomy is safe for benign lesions; however, such surgery for cancer remains controversial. The aim of this study is to compare outcomes in open versus laparoscopic gastrectomy. Data on patients undergoing open (n = 15) or laparoscopic (n = 52) gastrectomy revealed a mean age of 61.7 and 70.5 years, respectively ( P = .06). Mean operative time was 32.3 minutes longer in the laparoscopic group ( P = .24). The difference in median length of hospital stay was 3 days (open 12 days, laparoscopic 9 days). Postoperative morbidity (< 30 days) was not different; however, there were more early respiratory complications in the open group ( P = .009). There were 4/6 (66.7%) open and 2/29 (6.9%) cancer recurrences. Laparoscopic approach for treatment of gastric lesions is safe and does not have a deleterious effect on cancer-related outcome.