Objective: To investigate clinical efficacy and postoperative survival in proximal gastric cancer patients undergoing different types of radical gastrectomy and reconstruction. Methods: The clinical records of 82 patients with proximal gastric cancer undergoing radical gastrectomy from January 2006 to October 2011 were analyzed. Of the patients, 22 cases underwent proximal gastrectomy with esophageal-residual stomach anastomosis (esophagogastric anastomosis group), 40 cases underwent total gastrectomy with esophagojejunal Roux-en-Y anastomosis (esophagojejunal Roux-en-Y anastomosis group), and 20 cases underwent proximal gastrectomy with functional jejunal interposition (jejunal interposition group). The surgery-related parameters, and postoperative complications, nutritional status and survival rate among the three groups were compared. Results: The operative time and intraoperative blood loss in esophagogastric anastomosis group were significantly decreased compared with the other two groups, and the number of lymph nodes dissected was higher but the nutritional indexes were worse in esophagojejunal Roux-en-Y anastomosis group than those in the other two groups (all P<0.05). There was no statistical difference in incidence of overall postoperative complications (P>0.05), but the incidences of diarrhea and dumping syndrome in esophagojejunal Roux-Y anastomosis group were significantly higher than those in the other two groups (all P<0.05). No statistical difference was noted in 1- and 3- year survival rate among the three groups (χ2=0.891, P=0.554; χ2=0.419, P=0.831). Conclusion: The three procedures give similar postoperative survival rate for proximal gastric cancer, and of them, proximal gastrectomy plus esophageal-residual stomach anastomosis is less traumatic, while proximal gastrectomy with functional jejunal interposition offers better quality of life, so the procedure selection should be based on the actual clinical condition of the patient.