Objective To investigate the clinical safety and short-term efficacy of non-exposed endoscopic wall-inversion surgery (NEWS) combined with laparoscopic sentinel node navigation surgery (LSNNS) in the treatment of early gastric cancer. Methods A total of 7 patients with early gastric cancer who underwent NEWS combined with LSNNS at the Department of Gastrointestinal Surgery, Peking University People’s Hospital, from January 2025 to May 2026 were retrospectively enrolled. The clinicopathological data and perioperative follow-up data of the patients were collected and sorted to evaluate the clinical safety, radical resection efficacy, and application value of this surgical procedure. Results The median maximum lesion diameter of 7 patients was 2.0 (1.5-3.0) cm, and 2 cases were complicated with ulcers. The pathological types were mainly signet ring cell carcinoma and poorly differentiated adenocarcinoma, and tumor invasion into the submucosa was observed in 3 cases. All patients successfully completed NEWS combined with LSNNS without conversion to open surgery. The average operative time was (268.9±47.7) minutes, and the intraoperative blood loss ranged from 15 to 50 mL. Negative surgical margins were achieved in all patients, with 4 to 9 sentinel lymph nodes dissected per case, and postoperative pathology confirmed no lymph node metastasis. No severe complications such as hemorrhage, perforation or abdominal infection occurred during the perioperative period. Patients presented with mild postoperative pain and slight inflammatory stress response, and only 2 cases developed transient mild gastric emptying disorder. The median postoperative hospital stay was 5 (5-7) days. Conclusion NEWS combined with LSNNS is a safe, feasible and minimally invasive novel surgical approach. It can achieve complete full-thickness resection of lesions and individualized lymph node dissection for high-risk early gastric cancer with reliable perioperative safety, while preserving the anatomical structure and physiological function of the stomach.