Simple SummaryGastric cancer has a poor prognosis when diagnosed in advanced stages, but curative treatment is possible if an early diagnosis is made. Endoscopy represents an essential tool for the detection of early neoplastic and pre-neoplastic gastric lesions and for surveillance. Many endoscopy imaging technologies have been developed to increase diagnostic accuracy. In this review, we summarize these endoscopy technologies.AbstractGastric cancer is an aggressive disease with low long-term survival rates. An early diagnosis is essential to offer a better prognosis and curative treatment. Upper gastrointestinal endoscopy is the main tool for the screening and diagnosis of patients with gastric pre-neoplastic conditions and early lesions. Image-enhanced techniques such as conventional chromoendoscopy, virtual chromoendoscopy, magnifying imaging, and artificial intelligence improve the diagnosis and the characterization of early neoplastic lesions. In this review, we provide a summary of the currently available recommendations for the screening, surveillance, and diagnosis of gastric cancer, focusing on novel endoscopy imaging technologies.