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Background/Aims: Endoscopic resection (ER) is being increasingly recognized worldwide as a major curative option for selected cases of early gastric cancer (EGC). However, additive surgery is mandatory for the cases that have undergone non-curative ER. The aim of this study was to evaluate the effect of the time interval between ER and surgery on oncological safety and surgical outcomes. Methods: We analyzed 154 patients who underwent additive gastrectomy after ER due to non-curative resection between January 2007 and December 2011 at Severance and Gangnam Severance Hospital. Patients were divided into 2 groups according to the median time interval between ER and additive surgery such as group A (≤ 29days) and group B (> 29days). We retrospectively evaluated the clinicopathological characteristics, clinical outcomes, and operative/postoperative outcomes. We also analyzed subgroup which underwent gastrectomy by experienced surgeons. Experienced surgeon was defined as surgeon with more than five years of surgical experience for gastrectomy in order to adjust surgeon's experience factor. Results: Of the 154 patients, 78 (50.6%) were in group A and 76 (49.4%) in group B. There was no difference of clinicopathologic characteristics and oncological recurrence except for tumor size (A: 2.49±1.63 cm vs. B: 1.81±1.16 cm, P=0.002). Operation time (A: 222.41±79.26 min vs. B: 175.46±71.88 min, P<0.001), estimated intra-operative blood loss (A: 152.21±217.64 cc vs. B: 68.01±164.16 cc, P=0.007), time to start liquid diet (A: 3.27±1.20 day vs. B: 2.70±1.03 day, P=0.002), post-operative hospital day (A: 10.50±9.37 day vs. B: 7.17±4.49 day, P=0.006), and time of hemovac removal (A: 3.79±3.17 day vs. B: 2.28±3.66 day, P=0.007) were statistically different between two groups. There were no local recurrence and 3 cases of distant recurrence during follow-up period (A: 22.81±14.55 vs. B 30.61±17.27, P=0.003). The surgical time of 3 cases was 8 days, 8 days, and 100 days after ER, respectively. The results was also similar in subgroup which underwent gastrectomy by experienced surgeons. Conclusions: The time interval between ER and additive surgery may be associated with operative and postoperative outcomes though there is no association with oncological recurrence. A large-scale prospective study and long term follow-up should be necessary to recommend the optimal surgery time after ER in EGC.