Endoscopic submucosal dissection (ESD) for gastric lesions is a technique that allows en bloc resection of large lesions. ESD is mainly performed to resect large nonmalignant gastric lesions (not candidates for mucosectomy) or early gastric cancer that is limited to the mucosa or the first layer of the submucosa (< 500-μm penetration depth). In some technical cases, ESD with circumferential submucosal incision and dissection might be combined with final snare resection, the so-called hybrid resection technique. This article is part of an expert video encyclopedia.