Abstract: Objective 　To evaluate the value of longiludinal axis endoscopic ult rasonography (LAEUS) in the diagnosis of advanced gast ric carcinoma. Methods 　Twenty-nine consecutive patient s with advanced gastric carcinoma were underwent endoscopy with biopsy for pathology, LAEUS and LAEUS-guided puncture aspiratian for cell pathology, respectively. The result s were compared with those of surgical naked-eye inspections and LAEUS plus LAEUS-guided biopcy. Results 　Final diagnosis of gastric cancer made by endoscopy accounted for 100 %、86. 4 %、80 % and 0 in the patients with Borrmann I, II, III, and IV types of gastric carcinoma, respectively, whereas final diagnosis rate of gastric cancer made by LAE-US plus LAEUS-guided biopcy was 100 %. The diagnosis rate of TNM stages of gastric cancer made by LAEUS plus LAEUS-guided biopcy was 83. 75 % according to the pathological finding of surgical sample. Conclusion 　LAEUS is superior than endoscopy in diagnosis of advanced gastric carcinoma, especially in Borrmann Ⅳof advanced gastric carcinoma.