Objective: To investigate a reliable and effective anastomotic approach after excision of gastric cardia cancer, so as to improve the clinical efficacy. Methods: The clinical data of 110 patients undergoing hand-sewn anastomoses (hand-sewn group) and 180 patients undergoing anastomosis with tubular stapler (mechanical stapler anastomosis group) after gastric cardia tumor resection were retrospectively analyzed, and then the incidences of anastomosis-related complications of the two groups were compared. Results: There were no obvious differences in operative time and incidence of anastomotic bleeding between the two groups (both P>0.05). The incidence of anastomotic leakage, anastomotic stricture, reflux and hoarseness as well as the half-year mortality in mechanical stapler anastomosis group were lower than those of hand-sewn group (all P<0.05). No statistical difference was noted in 3-year survival rate between the two groups (P>0.05). Conclusion: Mechanical stapling anastomsis is more effective than hand suturing in reducing postoperative complications and mortality, and also has the advantages of being simple to perform and reliable results.